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Early repolarisation

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https://www.readbyqxmd.com/read/29129560/the-role-of-holter-monitoring-in-the-diagnosis-of-early-repolarisation-pattern
#1
Cheng-Cheng Ji, Xu-Miao Chen, Yun-Jiu Cheng, Li-Juan Liu, Kai Tang, Wei-Qi Zhu, Ying Huang, Wei-Ying Chen, Wei-Ying Chen, Su-Hua Wu
BACKGROUND: A slower heart rate can exaggerate J-point elevation in a 12-lead ECG. This study examined the role of Holter monitoring in the diagnosis of early repolarisation pattern (ERP). METHODS: We examined 24-hour Holter recordings of 4000 consecutive patients seen at an outpatient clinic, and found 500 patients (12.5%) with ERP (based on J-point elevation magnitude maximum value≥0.1mV on the Holter recording). The highest magnitude of J-point elevation, R wave amplitude, the ratio between J-point elevation magnitude and R-wave amplitude on the same ECG lead (J/R ratio), QRS interval, and QT/QTc interval were measured on the Holter recording and on a surface 12-lead ECG of the 500 patients with ERP...
October 20, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28883639/hysteretic-dynamics-of-multi-stable-early-afterdepolarisations-with-repolarisation-reserve-attenuation-a-potential-dynamical-mechanism-for-cardiac-arrhythmias
#2
Kunichika Tsumoto, Yasutaka Kurata, Kazuharu Furutani, Yoshihisa Kurachi
Some cardiovascular and non-cardiovascular drugs frequently cause excessive prolongation of the cardiac action potential (AP) and lead to the development of early afterdepolarisations (EADs), which trigger lethal ventricular arrhythmias. Combining computer simulations in APs with numerical calculations based on dynamical system theory, we investigated stability changes of APs observed in a paced human ventricular myocyte model by decreasing and/or increasing the rapid (I Kr) and slow (I Ks) components of delayed rectifying K(+) current...
September 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28842979/epicardial-ablation-utilizing-remote-magnetic-navigation-in-a-patient-with-brugada-syndrome-and-inferior-early-repolarization
#3
Paul Chun Yih Lim, Koonlawee Nademanee, Edward Chun Yi Lee, Wee Siong Teo
We report a case of epicardial ablation in a combined Brugada and inferior early repolarization syndrome patient with recurrent defibrillator therapy for spontaneous ventricular fibrillation. Electroanatomic mapping and ablation were achieved with remote magnetic navigation. Highly fractionated electrograms were seen epicardially in the anterior right ventricular outflow tract (RVOT) and at the anterior-inferior right ventricle. Ablation of the RVOT region resulted in resolution Brugada pattern electrocardiogram...
August 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28759083/a-rare-cause-of-early-repolarisation-in-an-adolescent-boy-with-chest-pain-myocardial-bridging
#4
Murat Deveci, Kadir Babaoğlu, Özlem Kayabey
Early repolarisation is a common electrocardiographic (ECG) finding characterised by J-point and ST segment elevation ≥ 0.1 mV in two or more adjacent leads. The ECG pattern of early repolarisation is relatively common in asymptomatic subjects. Early repolarisation pattern may be seen in secondary conditions such as hypothermia, autonomic nervous system disturbances, cocaine abuse, hypercalcaemia and myocardial ischaemia. We present a case of an adolescent boy with chest pain and concurrent ST-segment elevation...
May 23, 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/28534204/-ventricular-arrhythmias-in-ion-channel-diseases
#5
REVIEW
Christian Wolpert, Mara Vogel, Christian Nagel, Claudia Herrera-Siklody, Norman Rüb
In patients with ion channel disease the predominant arrhythmias are polymorphic ventricular tachycardias (VT), torsade de pointes tachycardia and ventricular fibrillation (VF). In only extremely rare cases is very rapid monomorphic ventricular tachycardia observed. This is why implantable cardioverter-defibrillators (ICDs) should always be programmed for treatment of VF only with high detection rates to avoid inappropriate discharges. In idiopathic VF and catecholaminergic polymorphic ventricular tachycardia (CPVT), no baseline electrocardiographic abnormalities can be detected, whereas in Brugada syndrome, long QT syndrome, early repolarisation syndrome and Anderson-Tawil syndrome alterations of the baseline ECG are very important to identify patients at risk...
June 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28526541/prevalence-of-early-repolarisation-pattern-in-children
#6
Philippe Maury, Céline Authenac, Anne Rollin, Yves Dulac, Pierre Mondoly, Christelle Cardin, Benjamin Monteil, Amin Bennadji, Rémi Gendre, Michel Galinier, Didier Carrié, Philippe Acar, Vanina Bongard, Sebastien Hascoet
BACKGROUND: Prevalence of early repolarisation ECG pattern (ER) has been repetitively determined in adults, but has not been reported in large unselected children populations so far. METHODS: ECG from 1000 successive healthy children from birth to 17years old were prospectively recorded and analyzed. ER was defined by ≥0.1mV J point elevation in at least two contiguous inferior or lateral ECG leads. Correlations with age, gender, ethnic origin, physical activity, Sokolow index and heart rate were performed...
September 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28051771/proarrhythmic-remodelling-of-the-right-ventricle-in-a-porcine-model-of-repaired-tetralogy-of-fallot
#7
David Benoist, Virginie Dubes, François Roubertie, Stephen H Gilbert, Sabine Charron, Marion Constantin, Delphine Elbes, Delphine Vieillot, Bruno Quesson, Hubert Cochet, Michel Haïssaguerre, Caroline Rooryck, Pierre Bordachar, Jean-Benoit Thambo, Olivier Bernus
OBJECTIVE: The growing adult population with surgically corrected tetralogy of Fallot (TOF) is at risk of arrhythmias and sudden cardiac death. We sought to investigate the contribution of right ventricular (RV) structural and electrophysiological remodelling to arrhythmia generation in a preclinical animal model of repaired TOF (rTOF). METHODS AND RESULTS: Pigs mimicking rTOF underwent cardiac MRI functional characterisation and presented with pulmonary regurgitation, RV hypertrophy, dilatation and dysfunction compared with Sham-operated animals (Sham)...
March 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28039169/long-term-prognosis-associated-with-early-repolarisation-pattern-in-chinese-population-with-atherosclerotic-risk-factors
#8
Yun-Jiu Cheng, Wei-Yi Mei, Xu-Miao Chen, Li-Juan Liu, Dong-Dan Zheng, Cheng-Cheng Ji, Kai Tang, Su-Hua Wu
BACKGROUND: Recent evidence has linked early repolarisation pattern (ERP) to sudden cardiac death (SCD) in patients without structural heart disease. However, no studies have clarified the prognostic value of ERP in people at high risk for atherosclerotic heart disease. METHODS: We prospectively assessed the prognostic significance of ERP on ECGs in a community-based population of 18 231 subjects with atherosclerotic risk factors (49.3% men, mean age 64.0 years)...
June 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28029353/intra-abdominal-hypertension-increases-spatial-qrs-t-angle-and-elevates-st-segment-j-point-in-healthy-women-undergoing-laparoscopic-surgery
#9
Wojciech Dabrowski, Andrzej Jaroszynski, Anna Jaroszynska, Ziemowit Rzecki, Todd T Schlegel, Manu Lng Malbrain
BACKGROUND: Intra-abdominal hypertension (IAH) impairs cardiovascular function, however an effect of IAH on cardiac electrophysiology has been poorly documented. The aim of this study was to evaluate the effect of IAH following pneumoperitoneum on vectorcardiographic variables reflecting cardiac repolarisation and depolarisation. METHODS: Otherwise healthy women undergoing elective gynaecological laparoscopy were studied. Intra-abdominal pressure (IAP), spatial QRS-T angle and ST-segment J-point (STJ) were observed during surgery and the early postoperative period...
March 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27759343/early-repolarisation-changes-in-ecg-are-they-benign-or-malignant
#10
Oruganti Sai Satish, K Sashikanth Srivastav
Till recently, ST segment elevation in the absence of conduction abnormalities or chest pain occurring particularly in young bradycardia individuals has been considered a normal variant called early repolarisation (ER). However, recent studies suggest a more worrisome picture as patients with history of idiopathic ventricular fibrillation showed increased prevalence of ER in ECG. ER is an ECG pattern characterised by elevation of the QRS-ST junction (J point) ≥ 2 mv from baseline in the inferior (II, III, aVF) or lateral (I, aVL, V4-V6) leads manifested as QRS slurring or notching...
July 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27617087/arrhythmogenic-cardiomyopathy-electrical-and-structural-phenotypes
#11
Deniz Akdis, Corinna Brunckhorst, Firat Duru, Ardan M Saguner
This overview gives an update on the molecular mechanisms, clinical manifestations, diagnosis and therapy of arrhythmogenic cardiomyopathy (ACM). ACM is mostly hereditary and associated with mutations in genes encoding proteins of the intercalated disc. Three subtypes have been proposed: the classical right-dominant subtype generally referred to as ARVC/D, biventricular forms with early biventricular involvement and left-dominant subtypes with predominant LV involvement. Typical symptoms include palpitations, arrhythmic (pre)syncope and sudden cardiac arrest due to ventricular arrhythmias, which typically occur in athletes...
August 2016: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/27617086/brugada-syndrome-and-early-repolarisation-distinct-clinical-entities-or-different-phenotypes-of-the-same-genetic-disease
#12
Giulio Conte, Maria Luce Caputo, François Regoli, Tiziano Moccetti, Pedro Brugada, Angelo Auricchio
Brugada and early repolarisation (ER) syndromes are currently considered two distinct inherited electrical disorders with overlapping clinical and electrocardiographic features. A considerable number of patients diagnosed with ER syndrome have a genetic mutation related to Brugada syndrome (BrS). Due to the high variable phenotypic manifestation, patients with BrS may present with inferolateral repolarisation abnormalities only, resembling the ER pattern. Moreover, the complex genotype-phenotype interaction in BrS can lead to the occurrence of mixed phenotypes with ER syndrome...
August 2016: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/27451270/gender-differences-in-the-electrocardiogram-screening-of-athletes
#13
Bram B Bessem, Matthijs M C de Bruijn, Wybe W Nieuwland
OBJECTIVES: Gender-related differences are frequently used in medicine. Electrocardiograms are also subject to such differences. This study evaluated gender differences in ECG parameters of young athletes, discussing the possible implications of these differences for ECG criteria used in the cardiovascular screening of young athletes. DESIGN: Observational cross-sectional study. METHODS: In 2013 and 2014 all the ECGs from the cardiovascular screenings performed at University Sports Medical Centre in Groningen of the student athletes who wanted to participate in a college sports program were collected...
February 2017: Journal of Science and Medicine in Sport
https://www.readbyqxmd.com/read/27326198/a-study-of-ecg-pattern-cardiac-structural-abnormalities-and-familial-tendency-in-patients-with-early-repolarisation-syndrome-in-south-india
#14
K G Madhu, Vijo George, T G Binu, R Ranjith, Subair Kunju, R Baiju, K S Mohanan, R Jayaram, V V Radhakrishnan
BACKGROUND: Early repolarisation (ER) on ECG, which was initially believed to be benign, has of late been considered otherwise. Brugada syndrome has recently been thought to be an extension of the ER spectrum, and the familial tendency of the ER pattern is being highlighted. With attention being drawn to ER's association with idiopathic ventricular fibrillation (VF), the prognosis and lineage of patients with an ER pattern are under scrutiny. AIMS: To analyse ER patterns on ECG, their presence in first-degree relatives and their association with structural heart disease...
2014: Heart Asia
https://www.readbyqxmd.com/read/27207979/ecg-features-and-proarrhythmic-potentials-of-therapeutic-hypothermia
#15
MULTICENTER STUDY
Woo Seok Lee, Gi-Byoung Nam, Sung-Hwan Kim, Jin Hee Choi, Uk Jo, Won Young Kim, Yong-Seog Oh, Kyu Nam Park, Guang-Won Seo, Ki-Hun Kim, Eun-Sun Jin, Kyoung-Suk Rhee, Laeyoung Jung, Ki-Won Hwang, Yoo Ri Kim, Chang Hee Kwon, Jun Kim, Kee-Joon Choi, You-Ho Kim
OBJECTIVE: Hypothermia can induce ECG J waves. Recent studies suggest that J waves may be associated with ventricular fibrillation (VF) in patients with structurally normal hearts. However, little is known about the ECG features, clinical significance or arrhythmogenic potentials of therapeutic hypothermia (TH)-induced J waves. METHODS: We analysed ECGs from 240 patients who underwent TH at six major university hospitals in Korea between August 2010 and December 2013...
October 1, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/26835120/early-repolarisation-syndrome-new-concepts
#16
Demosthenes G Katritsis, Bernard J Gersh, A John Camm
New concepts regarding early repolarisation syndrome are presented. Genetics and epidemiology data, as well as new evidence on the potential clinical significance of early repolarisation patterns, are discussed.
December 2015: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/26835108/early-repolarisation-what-should-the-clinician-do
#17
Manoj N Obeyesekere, Andrew D Krahn
The early repolarisation (ER) pattern is a common ECG finding. Most individuals with the ER pattern are at minimal risk for arrhythmic events. In others, ER increases the arrhythmic risk of underlying cardiac pathology. Rarely ER syndrome will manifest as a primary arrhythmogenic disorder causing ventricular fibrillation (VF). ER syndrome is defined as syncope attributed to ventricular arrhythmias or cardiac arrest attributed to ER following systematic exclusion of other etiologies. Some ECG features associated with ER portend a higher risk...
August 2015: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/26835035/body-surface-electrocardiographic-mapping-for-non-invasive-identification-of-arrhythmic-sources
#18
Ashok J Shah, Meleze Hocini, Patrizio Pascale, Laurent Roten, Yuki Komatsu, Matthew Daly, Khaled Ramoul, Arnaud Denis, Nicolas Derval, Frederic Sacher, Remi Dubois, Ryan Bokan, Sandra Eliatou, Maria Strom, Charu Ramanathan, Pierre Jais, Philippe Ritter, Michel Haissaguerre
The authors describe a novel three-dimensional, 252-lead electrocardiography (ECG) and computed tomography (CT)-based non-invasive cardiac imaging and mapping modality. This technique images potentials, electrograms and activation sequences (isochrones) on the epicardial surface of the heart. This tool has been investigated in the normal cardiac electrophysiology and various tachyarrhythmic, conduction and anomalous depo-repolarisation disorders. The clinical application of this system includes a wide range of electrical disorders like atrial arrhythmias (premature atrial beat, atrial tachycardia, atrial fibrillation), ventricular arrhythmias (premature ventricular beat, ventricular tachycardia) and ventricular pre-excitation (Wolff-Parkinson-White syndrome)...
April 2013: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/26202527/prevalence-and-determinants-of-the-early-repolarisation-pattern-in-a-group-of-young-high-endurance-rowers
#19
Marcin Konopka, Krystyna Burkhard-Jagodzińska, Krystyna Anioł-Strzyżewska, Wojciech Król, Andrzej Klusiewicz, Jolanta Chwalbińska, Andrzej Pokrywka, Dariusz Sitkowski, Mirosław Dłużniewski, Wojciech Braksator
BACKGROUND: The prevalence and significance of the early repolarisation (ER) pattern in the general population has raised a number of questions. Even less data are available on athletes. AIM: To determine the prevalence and determinants of ER in a group of young high endurance athletes. METHODS: We studied 117 rowers (46% women, mean age 17.5 ± 1.5 years, mean training duration 4.3 ± 1.8 years). On 12-lead electrocardiogram (ECG), we evaluated inferolateral leads for the presence of the ER pattern, defined as at least 0...
2016: Kardiologia Polska
https://www.readbyqxmd.com/read/26091640/biophysics-and-molecular-biology-of-cardiac-ion-channels-for-the-safety-pharmacologist
#20
REVIEW
Michael K Pugsley, Michael J Curtis, Eric S Hayes
Cardiac safety pharmacology is a continuously evolving discipline that uses the basic principles of pharmacology in a regulatory-driven process to generate data to inform risk/benefit assessment of a new chemical entity (NCE). The aim of cardiac safety pharmacology is to characterise the pharmacodynamic/pharmacokinetic (PK/PD) relationship of a drug's adverse effects on the heart using continuously evolving methodology. Unlike Toxicology, safety pharmacology includes within its remit a regulatory requirement to predict the risk of rare cardiotoxic (potentially lethal) events such as torsades de pointes (TdP), which is statistically associated with drug-induced changes in the QT interval of the ECG due to blockade of I Kr or K v11...
2015: Handbook of Experimental Pharmacology
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