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early repolarization syndrome

Xiaodong Huang, Tae Yun Kim, Gideon Koren, Bum-Rak Choi, Zhilin Qu
The occurrence of early afterdepolarizations (EADs) and increased dispersion of repolarization are two known factors for arrhythmogenesis in long QT syndrome. However, increased dispersion of repolarization tends to suppress EADs due to the source-sink effect, and thus how the two competing factors cause initiation of arrhythmias remains incompletely understood. Here we used optical mapping and computer simulation to investigate the mechanisms underlying spontaneous initiation of arrhythmias in type 2 long QT (LQT2) syndrome...
October 7, 2016: American Journal of Physiology. Heart and Circulatory Physiology
Gerrit Frommeyer, Catharina Clauss, Christian Ellermann, Harilaos Bogossian, Dirk G Dechering, Simon Kochhäuser, Florian Reinke, Christian Pott, Lars Eckardt
AIMS: The antiarrhythmic drug vernakalant exerts antiarrhythmic effects in atrial fibrillation. Recent experimental data suggest interactions with the late sodium current and antiarrhythmic effects in ventricular arrhythmias. We aimed at investigating whether treatment with vernakalant reduces polymorphic ventricular tachycardia (VT) in an experimental model of Long-QT-syndrome (LQTS). METHODS AND RESULTS: Twenty-nine isolated rabbit hearts were assigned to two groups and treated with erythromycin (300 µM, n = 15) or veratridine (0...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Enrique Velázquez-Rodríguez, Horacio Rodríguez-Piña, Alex Pacheco-Bouthillier, Marcelo Paz Jiménez-Cruz
BACKGROUND: Typical diagnostic, coved-type 1, Brugada ECG patterns fluctuate spontaneously over time with a high proportion of non-diagnostic ECG patterns. Insulin modulates ion transport mechanisms and causes hyperpolarization of the resting potential. We report our experience with unmasking J-ST changes in response to a dextrose-insulin test. METHODS: Nine patients, mean age 40.5±19.4years (range: 15-65years), presented initially with a non-diagnostic ECG pattern, which was suggestive of Brugada syndrome (group I)...
August 19, 2016: Journal of Electrocardiology
John J Wang, Olle Pahlm, Galen S Wagner, James W Warren, B Milan Horáček, John L Sapp
BACKGROUND: Existing criteria recommended by ACC/ESC for identifying patients with ST elevation myocardial infarction (STEMI) from the 12-lead ECG perform with high specificity (SP) but low sensitivity (SE). In our previous studies, we found that the SE of acute ischemia detection can be markedly improved without any loss of SP by calculating, from the 12-lead ECG, ST deviation in 3 "optimal" vessel-specific leads (VSLs). To further validate the method, we evaluated the SP performance using a dataset with non-ischemic ST-segment changes...
August 18, 2016: Journal of Electrocardiology
Xu-Miao Chen, Cheng-Cheng Ji, Yun-Jiu Cheng, Li-Juan Liu, Wei-Qi Zhu, Ying Huang, Wei-Ying Chen, Su-Hua Wu
BACKGROUND: Just as high-risk populations for cardiac arrest exist in patients with Brugada syndrome or long QT syndrome, high-risk and low-risk populations for cardiac arrest also exist in patients with early repolarization pattern (ERP). HYPOTHESIS: Electrocardiographic (ECG) characteristics can aid the risk stratification of patients with ERP. METHODS: Electrocardiographic parameters such as magnitude of J-point elevation and J/R ratio were measured...
September 6, 2016: Clinical Cardiology
Giulio Conte, Carlo de Asmundis, Juan Sieira, Giuseppe Ciconte, Giacomo Di Giovanni, Gian-Battista Chierchia, Ruben Casado-Arroyo, Giannis Baltogiannis, Erwin Ströker, Ghazala Irfan, Gudrun Pappaert, Angelo Auricchio, Pedro Brugada
BACKGROUND: The phenotypic heterogeneity of Brugada syndrome (BrS) can lead some patients to show an additional inferolateral early repolarization pattern (ERP), or fragmented QRS (f-QRS). The aim of the study was to investigate the prevalence and clinical impact of f-QRS, ERP or combined f-QRS/ERP in high-risk patients with BrS. METHODS AND RESULTS: Patients with spontaneous or drug-induced BrS and an indication to receive an implantable cardioverter-defibrillator (ICD) were considered eligible for this study...
September 23, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Kanae Hasegawa, Hiroshi Watanabe, Takashi Hisamatsu, Seiko Ohno, Hideki Itoh, Takashi Ashihara, Hideki Hayashi, Takeru Makiyama, Tohru Minamino, Minoru Horie
No abstract text is available yet for this article.
November 15, 2016: International Journal of Cardiology
Marloes Visser, Jasper J van der Smagt, Peter Loh, Jeroen F van der Heijden, Rutger J Hassink
No abstract text is available yet for this article.
November 15, 2016: International Journal of Cardiology
Ashok J Shah, Meleze Hocini, Arnaud Denis, Nicolas Derval, Frederic Sacher, Pierre Jais, Michel Haissaguerre
Primary electrical diseases manifest with polymorphic ventricular tachycardia (PMVT) and ventricular fibrillation (VF) and along with idiopathic VF contribute to about 10% of sudden cardiac deaths (SCDs) overall. These disorders include long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, short QT syndrome, and early repolarization syndrome. This article reviews the clinical electrophysiological management of PMVT/VF in a structurally normal heart affected with these disorders...
September 2016: Cardiac Electrophysiology Clinics
Weng-Chio Tam, Ming-Hsiung Hsieh, Yung-Kuo Lin, Jong-Shiuan Yeh
A 55-year-old male with underlying type 2 diabetes mellitus and hypertension presented at our emergency department with ventricular fibrillation-related cardiac arrest. Hyper-acute ST elevation myocardial infarction was the preliminary diagnosis by 12-lead electrocardiography, which simultaneously showed J point ST elevation and tall T waves. However, the echocardiography showed concentric left ventricle hypertrophy and preserved left ventricular systolic function with no regional wall motion abnormalities, and coronary angiography did not show any critical coronary artery lesion...
July 2016: Acta Cardiol Sin
Ben N Mercer, Gordon A Begg, Stephen P Page, Christopher P Bennett, Muzahir H Tayebjee, Saagar Mahida
The early repolarization (ER) pattern on the 12-lead electrocardiogram is characterized by J point elevation in the inferior and/or lateral leads. The ER pattern is associated with an increased risk of ventricular arrhythmias and sudden cardiac death (SCD). Based on studies in animal models and genetic studies, it has been proposed that J point elevation in ER is a manifestation of augmented dispersion of repolarization which creates a substrate for ventricular arrhythmia. A competing theory regarding early repolarization syndrome (ERS) proposes that the syndrome arises as a consequence of abnormal depolarization...
2016: Frontiers in Physiology
Ljubica Georgijević, Lana Andrić
Electrocardiography (ECG) is especially significant in pre-participation screening due to its ability to discover or to rise a suspicion for certain cardiovascular diseases and conditions that represent a serious health risk in athletes. Common, conditionally benign and training related ECG changes are sinus bradycardia and sinus arrhythmia, first degree atrioventricular block, incomplete right bundle branch block, benign early repolarization, and isolated QRS voltage criteria for left ventricular enlargement...
January 2016: Srpski Arhiv za Celokupno Lekarstvo
Arnon Adler, Sami Viskin
Genetic cardiac diseases related to potassium channelopathies are a group of relatively rare syndromes that includes long QT syndrome, short QT syndrome, Brugada syndrome, and early repolarization syndrome. Patients with these syndromes share a propensity for the development of life-threatening ventricular arrhythmias in the absence of significant cardiac structural abnormalities. Familial atrial fibrillation has also been associated with potassium channel dysfunction but differs from the other syndromes by being a rare cause of a common condition...
June 2016: Cardiac Electrophysiology Clinics
Greg Mellor, Christopher P Nelson, Claire Robb, Hariharan Raju, Yanushi Wijeyeratne, Christian Hengstenberg, Wibke Reinhard, Michael Papadakis, Sanjay Sharma, Nilesh J Samani, Elijah R Behr
BACKGROUND: The early repolarization (ER) pattern is associated with sudden death and has been shown to be heritable. Its significance when identified in families affected by sudden arrhythmic death syndrome (SADS) remains unclear. METHODS AND RESULTS: We analyzed 12-lead ECGs of 401 first-degree relatives of individuals who had died from SADS. The prevalence of ER patterns was compared with family-clustered controls. ER was more common in SADS family members than in controls (21% versus 8%; odds ratio: 5...
June 2016: Circulation. Arrhythmia and Electrophysiology
Brittan S Sutphin, Nicole J Boczek, Héctor Barajas-Martínez, Dan Hu, Dan Ye, David J Tester, Charles Antzelevitch, Michael J Ackerman
INTRODUCTION: Perturbations in the CACNA1C-encoded L-type calcium channel α-subunit have been linked recently to heritable arrhythmia syndromes, including Timothy syndrome, Brugada syndrome, early repolarization syndrome, and long QT syndrome. These heritable arrhythmia syndromes may serve as a pathogenic basis for autopsy-negative sudden unexplained death in the young (SUDY). However, the contribution of CACNA1C mutations to SUDY is unknown. OBJECTIVE: We set out to determine the spectrum, prevalence, and pathophysiology of rare CACNA1C variants in SUDY...
May 24, 2016: Congenital Heart Disease
C N Lang, G Koren, K E Odening
Long QT syndrome (LQTS) is a rare inherited channelopathy caused mainly by different mutations in genes encoding for cardiac K(+) or Na(+) channels, but can also be caused by commonly used ion-channel-blocking and QT-prolonging drugs, thus affecting a much larger population. To develop novel diagnostic and therapeutic strategies to improve the clinical management of these patients, a thorough understanding of the pathophysiological mechanisms of arrhythmogenesis and potential pharmacological targets is needed...
July 2016: Progress in Biophysics and Molecular Biology
Soumya R Mahapatra, Praloy Chakraborty
No abstract text is available yet for this article.
September 2015: Indian Pacing and Electrophysiology Journal
Alberto Bouzas-Mosquera, Jesús Peteiro, Francisco J Broullón, Nemesio Álvarez-García, Nicolás Maneiro-Melón, Patricia Pardo-Martinez, Marta Sagastagoitia-Fornie, Dolores Martínez, Juan C Yáñez, José Manuel Vázquez-Rodríguez
INTRODUCTION: Although cardiac stress testing may help establish the safety of early discharge in patients with suspected acute coronary syndromes and negative troponins, more cost-effective strategies are necessary. We aimed to develop a clinical prediction rule to safely obviate the need for cardiac stress testing in this setting. METHODS: A decision rule was derived in a prospective cohort of 3001 patients with acute chest pain and negative troponins, and validated in a set of 1473 subjects...
August 2016: American Journal of Emergency Medicine
Carlos Alberto Pastore, Nelson Samesima, Horácio G Pereira Filho, Bruna A Madaloso
BACKGROUND: The J-wave electrocardiographic patterns include early repolarization (ER) and Brugada syndrome; especially when ER is located in the anteroseptal leads (V1-V3), it can mimic the Brugada syndrome (BrS) ECG pattern and therefore mislead the diagnosis. We aimed to define the vectorcardiographic characteristics of BrS and ER using aspects of QRS complex loop, J-point and ST-segment. METHODS/RESULTS: Vectorcardiographic loops in the transverse plane (TP) of 14 BrS patients and 26 individuals with ER were analyzed and defined, and then a third group of 17 patients with non-characteristic ECG patterns were analyzed and compared with them...
May 2016: Journal of Electrocardiology
Chifumi Iizuka, Masahito Sato, Hitoshi Kitazawa, Yoshio Ikeda, Masaaki Okabe, Kiyotaka Kugiyama, Yoshifusa Aizawa
A 21-year-old man developed ventricular fibrillation (VF) while drinking alcohol and was admitted to our hospital. An electrocardiogram (ECG) on admission revealed remarkably prominent slurs on the terminal part of QRS complexes in the left precordial leads and a coved type ST elevation at higher intercostal spaces. After hypothermia therapy, he underwent implantation of an implantable cardioverter-defibrillator (ICD). Standard twelve-lead follow-up ECGs revealed early repolarization pattern and an intermittent coved type ST elevation...
July 2016: Journal of Electrocardiology
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