title: Early repolarization pattern: a marker of increased risk in patients with catecholaminergic polymorphic ventricular tachycardia.
abstract: OBJECTIVE
  The early repolarization pattern (ERP) has been shown to be associated with arrhythmias in patients with short QT syndrome, Brugada syndrome, and ischaemic heart disease. Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inherited arrhythmia syndrome and related to malignant ventricular tachyarrhythmias in a structurally normal heart. The aim of this study was to evaluate the prevalence of ERP and clinical events in patients with CPVT.
  
  
  RESULTS
  Digitalized resting 12-lead ECGs of patients were analysed for ERP and for repolarization markers (QT and Tpeak-Tendinterval). The ERP was diagnosed as 'notching' or 'slurring' at the terminal portion of QRS with ≥0.1 mV elevation in at least two consecutive inferior (II, III, aVF) and/or lateral leads (V4-V6, I, aVL). Among 51 CPVT patients (mean age 36 ± 15 years, 11 males), the ERP was present in 23 (45%): strictly in the inferior leads in 9 (18%) patients, in the lateral leads in 9 (18%) patients, and in infero-lateral leads in 5 (10%) patients. All patients with ERP were symptomatic at presentation (23 of 23 patients with ERP vs. 19 of 28 patients without ERP, P = 0.003). Syncope was also more frequent in patients with ERP (18 of 23 patients with ERP vs. 11 of 28 patients without ERP, P = 0.005).
  
  
  CONCLUSIONS
  A pathologic ERP is present in an unexpected large proportion (45%) of patients and is associated with an increased frequency of syncope. In patients with unexplained syncope and ERP at baseline, exercise testing should be performed to detect CPVT.
authors.affiliation: University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany erol.tueluemen@umm.de.|DZHK (German Centre for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Heidelberg/Mannheim, Germany.
authors.forename: Erol
authors.initials: E
authors.lastname: Tülümen
authors.affiliation: Department of Cardiovascular Medicine, Institute for Genetics of Heart Diseases (IfGH), University Hospital Münster, Münster, Germany.|Interdisciplinary Centre for Clinical Research (IZKF), University Hospital Münster, Münster, Germany.
authors.forename: Eric
authors.initials: E
authors.lastname: Schulze-Bahr
authors.affiliation: Department of Cardiovascular Medicine, Institute for Genetics of Heart Diseases (IfGH), University Hospital Münster, Münster, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Zumhagen
authors.affiliation: Department of Cardiovascular Medicine, Institute for Genetics of Heart Diseases (IfGH), University Hospital Münster, Münster, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Stallmeyer
authors.affiliation: Department of Cardiovascular Medicine, Institute for Genetics of Heart Diseases (IfGH), University Hospital Münster, Münster, Germany.
authors.forename: Guiscard
authors.initials: G
authors.lastname: Seebohm
authors.affiliation: Department of Medicine I, University Hospital Munich, Campus Grosshadern, Ludwig-Maximilians University, Munich, Germany.|DZHK (German Centre for Cardiovascular Research) Partner Site Munich, Munich, Germany.
authors.forename: Britt-Maria
authors.initials: BM
authors.lastname: Beckmann
authors.affiliation: Department of Medicine I, University Hospital Munich, Campus Grosshadern, Ludwig-Maximilians University, Munich, Germany.|DZHK (German Centre for Cardiovascular Research) Partner Site Munich, Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kääb
authors.affiliation: University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.|DZHK (German Centre for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Heidelberg/Mannheim, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Rudic
authors.affiliation: University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.|DZHK (German Centre for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Heidelberg/Mannheim, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Liebe
authors.affiliation: Department of Medicine-Cardiology, Nephrology and Internal Intensive Care Medicine, Klinikum Ludwigsburg, Ludwigsburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Wolpert
authors.affiliation: Department of Medicine-Cardiology, Nephrology and Internal Intensive Care Medicine, Klinikum Ludwigsburg, Ludwigsburg, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Herrera-Siklody
authors.affiliation: Department of Cardiology and Angiology, Rhythmology and Electrophysiology, Hannover Medical School, Hannover, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Veltmann
authors.affiliation: University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.|DZHK (German Centre for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Heidelberg/Mannheim, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Schimpf
authors.affiliation: University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.|DZHK (German Centre for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Heidelberg/Mannheim, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Borggrefe
mesh_terms: D000293:Adolescent; D058671:Adrenergic beta-1 Receptor Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D002648:Child; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D005260:Female; D005820:Genetic Testing; D005858:Germany; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013575:Syncope / Q000453:epidemiology* / Q000209:etiology; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D055815:Young Adult; D000098850:Polymorphic Catecholaminergic Ventricular Tachycardia
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists
keywords: CPVT; ECG; Early repolarization pattern; Syncope