Early repolarization pattern and syndrome — norm or pathology?
https://doi.org/10.33667/2078-5631-2020-25-38-41
Abstract
The review article is devoted to the diagnosis and clinical significance of early ventricular repolarization phenomenon and syndrome. Just 13 years ago, the phenomenon was recognized as an unambiguous version of the norm. However, the results of a series of multicenter studies have shown that the phenomenon is associated with an increased risk of sudden cardiac death. The following criteria are recognized as criteria for early repolarization: the presence of a notch or a junction wave on the descending part of the R wave with a concomitant (or absent) elevation of the ST segment (at the Jt point); J wave (point) ≥0.1mV peak elevation (at Jp point) in ≥2 adjacent 12-channel ECG leads, except for V1–3 leads; QRS duration, measured in leads with J wave (point) <120 ms. Early repolarization syndrome is a clinical condition involving a combination of the pattern of early repolarization and polymorphic ventricular tachycardia, ventricular fibrillation and/or sudden cardiac death in persons without structural heart disease. Treatment is required in patients with a symptom of ventricular tacharrhythmia or family history early repolarization with sudden cardiac death.
References
1. Shipley R.A., Halloran W.R. The four-lead electrocardiogram in 200 normal men and women // Amer. Heart J. — 1936. — № 11. — P. 325–345.
2. Tomaszewski W. Changement electrocardiographiques observes chez un homme mort de froid [Electrocardiographic changes observed in a man frozen to death] // Arch. Mal. Coeur. — 1938. — Vol. 31. — P. 525–528.
3. Grant R.P., Estes H.E., Doyle J.T. Spatial vector electrocardiography; the clinical characteristics of S-T and T vectors // Circulation. — 1951. — Vol. 3. — P. 182–197.
4. Аббакумов С.Д., Романов М.М., Стае М. Синдром преждевременной реполяризации желудочков // Кардиология. — 1979. — Т. 19, № 7. — С. 82–86.
5. Kambara H., Phillips M. Long-term elevation of early repolarisation syndrome (normal variant RS-T segment elevation) // Amer. J. Cardiol. — 1976. — Vol. 38, № 2. — P. 157–161.
6. Воробьев Л.П., Грибкова И.Н., Петрусенко Н.М. Возможные механизмы возникновения синдрома ранней реполяризации желудочков // Кардиология. — 1985. — Т. 25, № 4. — С. 110–112.
7. Скоробогатый А.М. Синдром ранней реполяризации желудочков // Кардиология. — 1986. — Т. 26, № 11. — С. 89–94.
8. Скоробогатый A.M. Электрокардиографическая диагностика и классификация синдрома ранней реполяризации желудочков // Клинич. медицина. — 1985. — Т. 63, № 1. — С. 47–51.
9. Бобров А.Л., Шуленин С.Н. Новая классификация синдрома ранней реполяризации желудочков: клиническое значение и применение // Кардиология СНГ. — 2006. — T. 4, № 1. — С. 123.
10. Шуленин С.Н., Бойцов С.А., Бобров А.Л. Клиническое значение синдрома ранней реполяризации желудочков, алгоритм обследования // Вестник аритмологии. — 2008. — № 50. — С. 33–39.
11. Haïssaguerre M., Derval N., Sacher F. et al. Sudden cardiac arrest associated with early repolarization // N. Engl. J. Med. — 2008. — Vol. 358. — P. 2016–2023.
12. Tikkanen J.T., Anttonen O., Junttila M.J. et al. Long-term outcome associated with early repolarization on electrocardiography // N. Engl. J. Med. — 2009. — Vol. 361. — P. 2529–2537.
13. Antzelevitch С., Yan G-X., Ackerman M.J. et al. J wave syndromes consensus conference: emerging concepts & gaps in knowledge // Heart Rhythm. — 2016. — Vol. 13, № 10. — P 295–324.
14. Noseworthy P.A., Tikkanen J.T., Porthan K. et al. The early repolarization pat- tern in the general population clinical correlates and heritability // J. Am. Coll. Cardiol. — 2011. — Vol. 57. — P. 2284–2289.
15. Nunn L.M., Bhar-Amato J., Lowe M.D. et al. Prevalence of J-point elevation in sudden arrhythmic death syndrome families // J. Am. Coll. Cardiol. — 2011. — Vol. 58. — P. 286–290.
16. Reinhard W., Kaess B.M., Debiec R. et al. Heritability of early repolarization: a population-based study // Circ. Cardiovasc. Genet. — 2011. — Vol. 4. — P. 134–138.
17. Chen M., Wang Q., Sun J. et al. Early repolarization in the inferior leads after accessory pathway ablation is highly correlated with atrial fibrillation in Wolff-Parkinson-White syndrome // J. Cardiol. — 2020. — Vol. 75, № 3. P. 323–329.
18. Matta M.G., Gulayin P.E., García-Zamora S. et al. Epidemiology of early repolarization pattern in an adult general population // Acta Cardiol. — 2019. — Vol. 1. — P. 11.
19. Miragoli M., Goldoni M., Demola P. et al. Left ventricular geometry correlates with early repolarization pattern in adolescent athletes // Scand. J. Med. Sci. Sports. — 2019. — Vol. 29, № 11. — P 1727–1735.
20. Fan J., Ji C.C., Cheng Y.J. et al. A novel mutation in GPD1L associated with early repolarization syndrome via modulation of cardiomyocyte fast sodium currents // Int. J. Mol. Med. — 2020. — Vol. 45, № 3. — P. 947–955.
21. Priori S.G., Wilde A.A., Horie M. et al. HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes // Heart Rhythm. — 2013. — Vol. 10, № 12. — P. 1932–1963.
22. Holkeri A., Eranti A., Haukilahti M.A. et al. Impact of age and sex on the long term prognosis associated with early repolarization in the general population // Heart Rhythm. — 2020. — Vol. 17, № 4. — P. 621–628.
Review
For citations:
Bobrov A.L. Early repolarization pattern and syndrome — norm or pathology? Medical alphabet. 2020;(25):38-41. (In Russ.) https://doi.org/10.33667/2078-5631-2020-25-38-41
Views:
118420
Email this article 