title: Relationship between J Waves and Vagal Activity in Patients Who Do Not Have Structural Heart Disease.
abstract: BACKGROUND
  J waves are associated with increased vagal activity in patients with idiopathic ventricular fibrillation in several studies to date. However, the relationship between J waves and autonomic nervous activity in patients without structural heart disease remains under investigation. We investigated whether the presence of a J wave on the surface electrocardiogram (ECG) was related to increased vagal activity in patients without structural heart disease.
  
  
  METHODS
  This retrospective study included 684 patients without structural heart disease who had undergone Holter ECG and surface ECG monitoring. Based on the presence of J waves on the surface ECG, patients were divided into two groups: those with J waves (group 1) and those without J waves (group 2). We compared heart rate variability (HRV), reflecting autonomic nervous activity, using 24-h Holter ECG between the groups.
  
  
  RESULTS
  J waves were present in 92 (13.4%) patients. Heart rate (HR) in group 1 was significantly lesser than that in group 2 (P = 0.031). The ratio of low-frequency (LF) components to high-frequency (HF) components (LF/HF) in group 1 was significantly lower than that in group 2 (P = 0.001). The square root of the mean squared differences of successive NN intervals in group 1 was also significantly higher than that in group 2 (P = 0.047). In a multivariate regression analysis, male sex, HR, and LF/HF ratio remained independent determinants for the presence of J waves (P = 0.039, P = 0.036, and P < 0.001, respectively).
  
  
  CONCLUSIONS
  In patients without structural heart disease, the presence of a J wave was associated with a slow HR, male sex, and increased vagal activity, independently.
authors.affiliation: Division of Cardiology, Inha University Hospital, Incheon, South Korea.
authors.forename: Yong-Soo
authors.initials: YS
authors.lastname: Baek
authors.affiliation: Division of Cardiology, Inha University Hospital, Incheon, South Korea.
authors.forename: Sang-Don
authors.initials: SD
authors.lastname: Park
authors.affiliation: Division of Cardiology, Inha University Hospital, Incheon, South Korea.
authors.forename: Man-Jong
authors.initials: MJ
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Inha University Hospital, Incheon, South Korea.
authors.forename: Sung-Woo
authors.initials: SW
authors.lastname: Kwon
authors.affiliation: Division of Cardiology, Inha University Hospital, Incheon, South Korea.
authors.forename: Sung-Hee
authors.initials: SH
authors.lastname: Shin
authors.affiliation: Division of Cardiology, Inha University Hospital, Incheon, South Korea.
authors.forename: Sung-Il
authors.initials: SI
authors.lastname: Woo
authors.affiliation: Division of Cardiology, Inha University Hospital, Incheon, South Korea.
authors.forename: Jun
authors.initials: J
authors.lastname: Kwan
authors.affiliation: Division of Cardiology, Inha University Hospital, Incheon, South Korea.
authors.forename: Dae-Hyeok
authors.initials: DH
authors.lastname: Kim
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000503:physiopathology*; D053840:Brugada Syndrome; D000075224:Cardiac Conduction System Disease; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006329:Heart Conduction System / Q000002:abnormalities* / Q000503:physiopathology; D006331:Heart Diseases / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014630:Vagus Nerve / Q000502:physiology* / Q000503:physiopathology*
keywords: Holter ECG; J wave; autonomic tone; electrocardiography; heart rate variability