AHA: Early Repolarization Linked to Cardiac Death Risk

Higher risk seen with J-point elevation in the inferior leads on standard electrocardiography
By Rick Ansorge
HealthDay Reporter

THURSDAY, Nov. 19 (HealthDay News) -- In middle-aged patients, early repolarization in the inferior leads of a standard electrocardiogram is associated with an increased long-term risk of cardiovascular death, according to a study published online Nov. 16 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions, held from Nov. 14 to 18 in Orlando, Fla.

Jani T. Tikkanen, of the University of Oulu in Finland, and colleagues studied 10,864 patients (mean age, 44 years) and observed an early repolarization pattern of 0.1 mV or more in 630 (5.8 percent) of them.

During a mean follow-up of 30 years, subjects with a J-point elevation of at least 0.1 mV in inferior leads had an increased risk of death from cardiac causes (adjusted relative risk, 1.28), and that those with a J-point elevation of more than 0.2 mV in inferior leads had a dramatically increased risk of death from cardiac causes and arrhythmia (adjusted relative risks, 2.98 and 2.92, respectively). In addition, early repolarization was a stronger predictor of death from cardiac causes than a prolonged QT interval corrected for heart rate and left ventricular hypertrophy.

"Our community-based study shows that J-point elevation in the inferior leads on standard electrocardiography is not an innocuous finding in middle-aged subjects," the authors conclude. "Future clinical and experimental studies should focus on understanding the exact mechanisms and reasons for this pattern and ultimately on devising strategies to prevent premature death from cardiac causes in subjects with this pattern."

One author reported receiving grant support from Instrumentarium Science Foundation and Orion Pharmos Science Foundation.

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