title: Role of electrophysiological studies in predicting risk of ventricular arrhythmia in early repolarization syndrome.
abstract: BACKGROUND
  The early repolarization (ER) pattern is associated with an increased risk of arrhythmogenic sudden death. However, strategies for risk stratification of patients with the ER pattern are not fully defined.
  
  
  OBJECTIVE
  This study sought to determine the role of electrophysiology studies (EPS) in risk stratification of patients with ER syndrome.
  
  
  METHODS
  In a multicenter study, 81 patients with ER syndrome (age 36 ± 13 years, 60 males) and aborted sudden death due to ventricular fibrillation (VF) were included. EPS were performed following the index VF episode using a standard protocol. Inducibility was defined by the provocation of sustained VF. Patients were followed up by serial implantable cardioverter-defibrillator interrogations.
  
  
  RESULTS
  Despite a recent history of aborted sudden death, VF was inducible in only 18 of 81 (22%) patients. During follow-up of 7.0 ± 4.9 years, 6 of 18 (33%) patients with inducible VF during EPS experienced VF recurrences, whereas 21 of 63 (33%) patients who were noninducible experienced recurrent VF (p = 0.93). VF storm occurred in 3 patients from the inducible VF group and in 4 patients in the noninducible group. VF inducibility was not associated with maximum J-wave amplitude (VF inducible vs. VF noninducible; 0.23 ± 0.11 mV vs. 0.21 ± 0.11 mV; p = 0.42) or J-wave distribution (inferior, odds ratio [OR]: 0.96 [95% confidence interval (CI): 0.33 to 2.81]; p = 0.95; lateral, OR: 1.57 [95% CI: 0.35 to 7.04]; p = 0.56; inferior and lateral, OR: 0.83 [95% CI: 0.27 to 2.55]; p = 0.74), which have previously been demonstrated to predict outcome in patients with an ER pattern.
  
  
  CONCLUSIONS
  Our findings indicate that current programmed stimulation protocols do not enhance risk stratification in ER syndrome.
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France. Electronic address: saagar7m7@yahoo.co.uk.
authors.forename: Saagar
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authors.lastname: Mahida
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France.
authors.forename: Nicolas
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authors.lastname: Derval
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France.
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authors.affiliation: Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France.
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authors.affiliation: Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France.
authors.forename: Seigo
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authors.affiliation: Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France.
authors.forename: Laurent
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authors.lastname: Roten
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France.
authors.forename: Han S
authors.initials: HS
authors.lastname: Lim
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Denis
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France.
authors.forename: Pierre
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authors.lastname: Bordachar
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France.
authors.forename: Philippe
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authors.lastname: Ritter
authors.affiliation: Centre Hospitalier Universitaire de Nantes, Nantes, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Probst
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France.
authors.forename: Mélèze
authors.initials: M
authors.lastname: Hocini
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France.
authors.forename: Pierre
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authors.lastname: Jaïs
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France.
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mesh_terms: D000328:Adult; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D004562:Electrocardiography / Q000379:methods*; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D015994:Incidence; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*
keywords: early repolarization; sudden cardiac death; ventricular fibrillation