The Role of the Ratio of J-Point Elevation Magnitude and R-Wave Amplitude on the Same ECG Lead in the Risk Stratification of Subjects With Early Repolarization Pattern.
BACKGROUND
Just as high-risk populations for cardiac arrest exist in patients with Brugada syndrome or long QT syndrome, high-risk and low-risk populations for cardiac arrest also exist in patients with early repolarization pattern (ERP).


OBJECTIVE
Electrocardiographic (ECG) characteristics can aid the risk stratification of patients with ERP.


METHODS
Electrocardiographic parameters such as magnitude of J-point elevation and J/R ratio were measured. The magnitude of J-point elevation, leads with J points elevated, J/R ratio, morphology of the ST segment, and QT/QTc interval were used in comparative analysis in 2 groups: 57 patients with ERP and cardiac arrest (cardiac arrest group) and 100 patients with ERP but without cardiac arrest (control group).


RESULTS
There was no statistical difference in clinical characteristics of the 2 groups. The J/R ratio in the cardiac arrest group was significantly higher than in the control group (26.8% ± 18.1% vs 16.3% ± 10.3%, respectively; P < 0.001) and the proportion of horizontal/descending ST segments (70.2%) was significantly higher than in the control group (29.0%), but the proportion of ascending/upsloping ST segments (29.8%) was significantly lower than in the control group (71.0%; P < 0.001). Multivariate logistic regression revealed that higher J/R ratio and horizontal/descending ST segment were independently associated with increased risk of cardiac arrest in patients with ERP.


CONCLUSIONS
In patients with ERP and cardiac arrest, J/R ratios were relatively higher and mostly with horizontal/descending ST segments, suggesting that J/R ratio and ST-segment morphology may be used as indicators for risk stratification in patients with ERP.
Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Xu-Miao
XM
Chen
Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Cheng-Cheng
CC
Ji
Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Yun-Jiu
YJ
Cheng
Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Li-Juan
LJ
Liu
Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Wei-Qi
WQ
Zhu
Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Ying
Y
Huang
Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Wei-Ying
WY
Chen
Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Su-Hua
SH
Wu
D000200:Action Potentials; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006323:Heart Arrest / Q000175:diagnosis / Q000209:etiology*; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
Arrhythmia/all; Electrocardiography ambulatory ECG; sudden death