Early repolarization with horizontal ST segment may be associated with aborted sudden cardiac arrest: a retrospective case control study

BMC Cardiovascular Disorders

Research Article

Seong Woo Han¹  Kyu-Hyung Ryu²  Sung Hea Kim³  Hyun-Joong Kim³  Sang Man Jung³  Do Young Kim³  Soon Yong Suh⁴ 

[1] Department of Cardiology, Korea Guro University Hospital, Seoul, South Korea;Department of Internal Medicine, College of Medicine, Hallym University, Seoul, South Korea;Division of Cardiology, Department of Internal Medicine, Hallym University Medical Center, 94-200 Yeongdeungpo-Dong, Yeongdeungpo-Gu, 150-719, Seoul, South Korea;Department of Internal Medicine, Konkuk University School of Medicine, Konkuk, South Korea;Heart Center, Gachon University of Medicine and Science, Gil Hospital, Incheon, South Korea;

关键词: Sudden cardiac death;    Early repolarization;    ST segment;   

DOI  :  10.1186/1471-2261-12-122

 received in 2012-06-02, accepted in 2012-12-04,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundRisk stratification of the early repolarization pattern (ERP) is needed to identify malignant early repolarization. J-point elevation with a horizontal ST segment was recently suggested as a malignant feature of the ERP. In this study, the prevalence of the ERP with a horizontal ST segment was examined among survivors of sudden cardiac arrest (SCA) without structural heart disease to evaluate the value of ST-segment morphology in risk stratification of the ERP.MethodsWe reviewed the data of 83 survivors of SCA who were admitted from August 2005 to August 2010. Among them, 25 subjects without structural heart disease were included. The control group comprised 60 healthy subjects who visited our health promotion center; all control subjects were matched for age, sex, and underlying disease (diabetes mellitus, hypertension). Early repolarization was defined as an elevation of the J point of at least 0.1 mV above the baseline in at least two continuous inferior or lateral leads that manifested as QRS slurring or notching. An ST-segment pattern of <0.1 mV within 100 ms after the J point was defined as a horizontal ST segment.ResultsThe SCA group included 17 men (64%) with a mean age of 49.7 ± 14.5 years. The corrected QTc was not significantly different between the SCA and control groups (432.7 ± 37.96 vs. 420.4 ± 26.3, respectively; p = 0.089). The prevalence of ERP was not statistically different between the SCA and control groups (5/25, 20% vs. 4/60, 6.7%, respectively; p = 0.116). The prevalence of early repolarization with a horizontal ST segment was more frequent in the SCA than in the control group (20% vs. 3.3%, respectively; p = 0.021). Four SCA subjects (16%) and one control subject (1.7%) had a J-point elevation of >2 mm (p = 0.025). Four SCA subjects (16%) and one (1.7%) control subject had an ERP in the inferior lead (p = 0.025).ConclusionThe prevalence of ERP with a horizontal ST segment was higher in patients with aborted SCA than in matched controls. This result suggests that ST morphology has value in the recognition of malignant early repolarization.

【 授权许可】

Unknown   
© Kim et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.