Document Detail

Early repolarization is an independent predictor of occurrences of ventricular fibrillation in the very early phase of acute myocardial infarction.
MedLine Citation:
PMID:  22534250     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Recent evidence has linked early repolarization (ER) to idiopathic ventricular fibrillation (VF) in patients without structural heart disease. However, no studies have clarified whether or not there is an association between ER and the VF occurrences after the onset of an acute myocardial infarction (AMI).
METHODS AND RESULTS: This study retrospectively included 220 consecutive patients with an AMI (57 female; mean age, 69±11 years) in whom the 12-lead ECGs before the AMI onset could be evaluated. The patients were classified on the basis of a VF occurrence within 48 hours after the AMI onset. Early repolarization was defined as an elevation of the QRS-ST junction of >0.1 mV from baseline in at least 2 inferior or lateral leads, manifested as QRS slurring or notching. Twenty-one (10%) patients had a VF occurrence within 48 hours of the AMI onset. A multivariate analysis revealed that ER (odds ratio [OR], 7.31; 95% confidence interval [CI], 2.21-24.14; P<0.01), a time from the onset to admission of <180 minutes (OR, 3.77; 95% CI, 1.13-12.59; P<0.05), and a Killip class greater than I (OR, 13.60; 95% CI, 3.43-53.99; P<0.001) were independent predictors of VF occurrences. As features of the ER pattern, a J-point elevation in the inferior leads, greater magnitude of the J-point elevation, notched morphology of the ER, and ER with a horizontal/descending ST segment, all were significantly associated with a VF occurrence.
CONCLUSIONS: The presence of ER increased the risk of VF occurrences within 48 hours after the AMI onset.
Yoshihisa Naruse; Hiroshi Tada; Yoshie Harimura; Mayu Hayashi; Yuichi Noguchi; Akira Sato; Kentaro Yoshida; Yukio Sekiguchi; Kazutaka Aonuma
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study     Date:  2012-04-24
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  5     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-20     Completed Date:  2012-09-04     Revised Date:  2013-02-04    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  506-13     Citation Subset:  IM    
Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, and Tsukuba Medical Center Hospital, Ibaraki, Japan.
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MeSH Terms
Follow-Up Studies
Japan / epidemiology
Middle Aged
Myocardial Infarction / complications*,  physiopathology
Retrospective Studies
Risk Factors
Time Factors
Ventricular Fibrillation / epidemiology,  etiology,  physiopathology*
Comment In:
Circ Arrhythm Electrophysiol. 2012 Dec;5(6):e114; author reply e115   [PMID:  23250557 ]

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