In the last few years, several reports have appeared implying a linkage between sudden cardiac death in the absence of underlying heart disease and the presence of electrocardiographic features suggestive of early repolarization. However, these features often included ST elevation in inferior leads (II, III and aVF), and lateral leads (V6) as well as the mid precordial leads and slurring of the terminal portion of the QRS complex as well as a notch. Antzelevitch and co-workers coined the term “J wave syndromes” and performed some elegant basic electrophsiologic studies that suggested a possible mechanism underlying the development of ventricular fibrillation. At present, there is debate concerning the appropriate designation and interpretation of these findings and considerable skepticism about whether the electrocardiographic interpretation or management of patients with ECG findings of early repolarization should be modified. The interested reader is referred to the initial report by Haisseguerre et al, the review and perspective of Rosso et al, the review by Anzelevitch and Yan, the comments of Surawicz and Macfarlane, and the complimentary studies of Uberoi et al and Muramoto et al in ambulatory asymptomatic subjects. References for the interested reader:
- Haissseguerre et al. N Engl J Med; 358: 2016-2023, 2008
- Rosso et al. Heart Rhythm; 8: 923-929, 2011
- Anzelevitch and Yan. Heart Rhythm; 7:549-558, 2010
- Surawicz and Macfarlane; J Am Coll Cardiol; 57: 1584-1586, 2011
- Uberoi et al; Circulation; 124: 2208-2214, 2011 6. Muramoto et al; J Electrocardiology (in press)