Early repolarization: Difference between revisions
No edit summary |
No edit summary |
||
| Line 5: | Line 5: | ||
{{SK}} early repolarization pattern; early repol; early repol variant | {{SK}} early repolarization pattern; early repol; early repol variant | ||
== Overview == | == Overview == | ||
Early repolarization is defined as notching or slurring of the morphology of the terminal [[QRS complex]] or [[J-point]] elevation >0.1 mV above baseline in at least 2 lateral or inferior leads.<ref>Patel RV et al; doi: 10.1161/CIRCEP.109.921130</ref> Early repolarization is a normal ECG variant that is most commonly seen in young males. It can be confused with [[ST elevation MI]] and [[pericarditis]]. | |||
Early repolarization is defined as notching or slurring morphology of the terminal QRS complex or J-point elevation >0.1 mV above baseline in at least 2 lateral or inferior leads.<ref>Patel RV et al; doi: 10.1161/CIRCEP.109.921130</ref> | |||
== Natural History, Complications and Prognosis == | == Natural History, Complications and Prognosis == | ||
| Line 22: | Line 17: | ||
*The [[J point]] is frequently elevated (where the QRS joins the concave ST elevation). | *The [[J point]] is frequently elevated (where the QRS joins the concave ST elevation). | ||
=== Differentiating | === Differentiating Early Repolarization From Pericarditis === | ||
[[Image:Pericarditis vs early repol.gif|center|300px|Peicarditis versus Early repolarization]] | |||
{| align="center" | {| align="center" | ||
! | ! | ||
|-valign="top" | |-valign="top" | ||
| | | | ||
|[[Image:Early repolarisation.jpeg|thumb|Early repolarization]] | |[[Image:Early repolarisation.jpeg|thumb|Early repolarization]] | ||
|[[Image:Benign early repolarization.jpg|thumb|Benign early repolarization with J point elevation, concave shaped up-sloping ST sgment, notching of the J point, prominent T waves]] | |[[Image:Benign early repolarization.jpg|thumb|Benign early repolarization with J point elevation, concave shaped up-sloping ST sgment, notching of the J point, prominent T waves]] | ||
Revision as of 18:41, 23 September 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: early repolarization pattern; early repol; early repol variant
Overview
Early repolarization is defined as notching or slurring of the morphology of the terminal QRS complex or J-point elevation >0.1 mV above baseline in at least 2 lateral or inferior leads.[1] Early repolarization is a normal ECG variant that is most commonly seen in young males. It can be confused with ST elevation MI and pericarditis.
Natural History, Complications and Prognosis
A case control study of 120 post MI patients with implantable cardioverter-cefibrillators (ICDs) demonstrated that early repolarization was more frequently observed among patients with documented episodes of VT/VF (32% vs. 8%, p=0.005). The leads demonstrating early repolarization were more often the inferior leads (23% vs. 8%, p=0.03). A trend was observed for the lateral leads (V4-V6) as well (12% vs. 3%, p=0.11). In contrast, leads I and aVL were not commonly involved (3% vs. 0%). The morphology of the ST segment was critical and a notch in the ST segment was observed more frequently among patients with VT/VF (28% vs. 7%, p=0.008). In contrast, J-point elevation and slurring of the ST segment surprisingly were not associated with ventricular arrhythmias.[2]
Diagnosis
- Early repolarization is exacerbated by bradycardia, and carotid sinus massage or vagal maneuvers may exacerbate the variant.
- The J point is frequently elevated (where the QRS joins the concave ST elevation).
Differentiating Early Repolarization From Pericarditis
 |
 |
Only lead V6 is used to distinguish the two diagnoses. As shown in the figure to the left, If A/B > 25%, suspect pericarditis. If A/B < 25%, suspect early repolarization.