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Early repolarisation

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)...
October 8, 2016: Heart: Official Journal of the British Cardiac Society
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)...
December 30, 2016: Heart: Official Journal of the British Cardiac Society
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
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
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
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
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...
July 6, 2016: Journal of Science and Medicine in Sport
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
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
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
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
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
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
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
Abdulrahman Naseef, Elijah R Behr, Velislav N Batchvarov
The Brugada syndrome (BrS) is a malignant, genetically-determined, arrhythmic syndrome manifesting as syncope or sudden cardiac death (SCD) in individuals with structurally normal hearts. The diagnosis of the BrS is mainly based on the presence of a spontaneous or Na + channel blocker induced characteristic, electrocardiographic (ECG) pattern (type 1 or coved Brugada ECG pattern) typically seen in leads V1 and V2 recorded from the 4th to 2nd intercostal (i.c.) spaces. This pattern needs to be distinguished from similar ECG changes due to other causes (Brugada ECG phenocopies)...
April 2015: Journal of the Saudi Heart Association
Hitesh B Mistry, Mark R Davies, Giovanni Y Di Veroli
There is currently a strong interest in using high-throughput in-vitro ion-channel screening data to make predictions regarding the cardiac toxicity potential of a new compound in both animal and human studies. A recent FDA think tank encourages the use of biophysical mathematical models of cardiac myocytes for this prediction task. However, it remains unclear whether this approach is the most appropriate. Here we examine five literature data-sets that have been used to support the use of four different biophysical models and one statistical model for predicting cardiac toxicity in numerous species using various endpoints...
2015: Frontiers in Pharmacology
Sebastian Stankala, Jerzy Sacha, Jarosław Bugajski, Andrzej Wester
No abstract text is available yet for this article.
2015: Kardiologia Polska
A O Verkerk, H L Tan, T Baartscheer, J H Ravesloot
OBJECTIVES: The proarrhythmic, early afterdepolarisations during phase two of the action potential (phase-2 EADs) are associated with secondary Ca(2+) release from the sarcoplasmic reticulum. This makes it probable that the Ca(2+)-activated Cl(-) current (ICl(Ca)) may contribute to phase-2 EADs. Activation of ICl(Ca) during phase two of the action potential will result in a repolarising current and may thus be expected to prevent excessive depolarisation of phase-2 EADs. The present study was designed to test this hypothesis...
December 2002: Netherlands Heart Journal
Meagan M Wasfy, James DeLuca, Francis Wang, Brant Berkstresser, Kathryn E Ackerman, Aaron Eisman, Gregory D Lewis, Adolph M Hutter, Rory B Weiner, Aaron L Baggish
BACKGROUND/AIM: The international governing body for competitive rowing recently mandated the inclusion of 12-lead ECG during preparticipation screening. We therefore sought to describe normative ECG characteristics and to examine the prevalence of abnormal ECG findings as defined by contemporary athlete ECG interpretation criteria among competitive rowers. METHODS: Competitive rowers (n=330, 56% male) underwent standard 12-lead ECG at the time of collegiate preparticipation screening...
February 2015: British Journal of Sports Medicine
Kamal K Sethi, Kabir Sethi, Surendra K Chutani
J wave syndrome has emerged as a significant cause of Idiopathic ventricular fibrillation (IVF) responsible for sudden cardiac death. A large body of data is now available on genesis, genetics and ionic mechanisms of J wave syndromes. Two of these viz., Early repolarization syndrome (ER) and Brugada syndrome (BrS) are fairly well characterized enabling correct diagnosis in most patients. The first part of repolarization of ventricular myocardium is governed by Ito current i.e., rapid outward potassium current...
July 2014: Indian Heart Journal
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