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Early Repolarization

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1. Electrocardiographic Early Repolarization

Electrocardiographic Early Repolarization Electrocardiographic Early Repolarization | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January 2019 This site uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share on Jump to Free (...) Access article Electrocardiographic Early Repolarization A Scientific Statement From the American Heart Association , MD, Chair , MD, PhD , MBChB, DPhil, FAHA , MD, FAHA , MD, MPH, FAHA , MD , MD, FAHA , MD, MAS , and MD, FAHA MDon behalf of the American Heart Association Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology and Council on Functional Genomics and Translational Biology Kristen K. Patton , Patrick T. Ellinor , Michael Ezekowitz , Peter Kowey , Steven

2016 American Heart Association

2. Electrophysiological Basis for Early Repolarization Syndrome (PubMed)

Electrophysiological Basis for Early Repolarization Syndrome During last centuries, Early Repolarization pattern has been interpreted as an ECG manifestation not linked to serious cardiovascular events. This view has been challenged on the basis of sporadic clinical observations that linked the J-wave with ventricular arrhythmias and sudden cardiac death. The particular role of this characteristic pattern in initiating ventricular fibrillation has been sustained by clinical descriptions (...) of a marked and consistent J-wave elevation preceding the onset of the ventricular arrhythmia. Until now, Early Repolarization syndrome patients have been evaluated using ECG and theorizing different interpretations of the findings. Nonetheless, ECG analysis is not able to reveal all depolarization and repolarization properties and the explanation for this clinical events. Recent studies have characterized the epicardial substrate in these patients on the basis of high-resolution data, in an effort

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2018 Frontiers in cardiovascular medicine

3. Cardiac action potential repolarization revisited: early repolarization shows all‐or‐none behaviour (PubMed)

Cardiac action potential repolarization revisited: early repolarization shows all‐or‐none behaviour In healthy mammalian hearts the action potential (AP) waveform initiates and modulates each contraction, or heartbeat. As a result, AP height and duration are key physiological variables. In addition, rate-dependent changes in ventricular AP duration (APD), and variations in APD at a fixed heart rate are both reliable biomarkers of electrophysiological stability. Present guidelines (...) for the likelihood that candidate drugs will increase arrhythmias rely on small changes in APD and Q-T intervals as criteria for safety pharmacology decisions. However, both of these measurements correspond to the final repolarization of the AP. Emerging clinical evidence draws attention to the early repolarization phase of the action potential (and the J-wave of the ECG) as an additional important biomarker for arrhythmogenesis. Here we provide a mechanistic background to this early repolarization syndrome

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2017 The Journal of physiology

4. Prevalence and Significance of an Early Repolarization Electrocardiographic Pattern and Its Mechanistic Insight Based on Cardiac Magnetic Resonance Imaging in Patients With Acute Myocarditis. (PubMed)

Prevalence and Significance of an Early Repolarization Electrocardiographic Pattern and Its Mechanistic Insight Based on Cardiac Magnetic Resonance Imaging in Patients With Acute Myocarditis. An early repolarization electrocardiographic (ER-ECG) pattern is caused by various pathophysiological conditions and is reported to be a predictor of life-threatening ventricular tachyarrhythmias. However, little evidence has been reported on the prevalence and significance of the ER-ECG pattern in acute (...) pattern, which was defined as terminal QRS notching or slurring with an amplitude of >0.1 mV in at least 2 inferior or lateral leads (early repolarization [ER] group), whereas the remaining 21 cases had broad ST-segment elevation or pathological Q waves (non-ER group). The cardiac troponin T level was significantly higher in the non-ER group than ER group (3.2±4.3 versus 0.9±1.2 ng/mL; P=0.036). The ECG changes returned to baseline along with the normalization of the cardiac biomarkers. Nine of the 21

2019 Circulation. Arrhythmia and electrophysiology

5. A de novo gain-of-function KCND3 mutation in early repolarization syndrome. (PubMed)

A de novo gain-of-function KCND3 mutation in early repolarization syndrome. Early repolarization syndrome (ERS) is characterized by J-point elevation on electrocardiograms and ventricular fibrillation (VF). Early repolarization arises from augmentation of the transmural electrical gradient in the cardiac action potential; therefore, the transient outward potassium current (Ito) has been regarded as a key candidate current for elucidating the mechanism of ERS. KCND3 encoding Kv4.3, an α-subunit (...) study confirmed the relationship between the novel KCND3 mutation and early repolarization on electrocardiograms.A novel KCND3 heterozygous mutation was found to be associated with ERS. The pathogenesis can be explained by the increased Ito. Genetic screening for KCND3 could be useful for understanding the pathogenesis and selecting effective treatment.Copyright © 2019. Published by Elsevier Inc.

2019 Heart Rhythm

6. Mapping and Ablation of Ventricular Fibrillation Associated with Early Repolarization Syndrome. (PubMed)

Mapping and Ablation of Ventricular Fibrillation Associated with Early Repolarization Syndrome. Background: We conducted a multicenter study to evaluate mapping and ablation of ventricular fibrillation (VF) substrates or VF triggers in early repolarization syndromes (ERS) or J-wave syndrome (JWS). Methods: We studied 52 ERS patients (4 females; median age, 35 years) with recurrent VF episodes. Body-surface electrocardiographic imaging (ECGI) along with endocardial and epicardial electroanatomic

2019 Circulation

7. Paper published: Terminal QRS distortion not found in any ECG of Early Repolarization

Paper published: Terminal QRS distortion not found in any ECG of Early Repolarization Dr. Smith's ECG Blog: Paper published: Terminal QRS distortion not found in any ECG of Early Repolarization Sunday, November 13, 2016 This ECG comes from a 30-something with chest pain. Is it early repolarization? Or is it LAD occlusion? The paper below helps to make this diagnosis. See at bottom for full explanation This paper is now published Daniel Lee, Brooks Walsh, Stephen W. Smith. Terminal QRS (...) distortion is present in anterior myocardial infarction but absent in early repolarization. , November 2016, Pages 2182–2185 Here I show it again: So, the only plausible reasons for ST elevation are 1) LAD occlusion or 2) Early Repolarization. One might be tempted to apply the formula that helps to differentiate the two. However, when we studied these ECGs, we excluded patients with features that made STEMI "obvious," or at least not subtle. These features included Q-waves and Terminal QRS distortion

2016 Dr Smith's ECG Blog

8. Is this STEMI? LVH? Early Repolarization?

Is this STEMI? LVH? Early Repolarization? Dr. Smith's ECG Blog: Is this STEMI? LVH? Early Repolarization? Friday, October 28, 2016 This 60-something with diabetes presented with abdominal pain, nausea, and vomiting. We all know that diabetics with acute MI may present like this (see this case: ). An ECG was recorded: This was the automated interpretation: SINUS RHYTHM LEFT VENTRICULAR HYPERTROPHY AND ST-T CHANGE ST ELEVATION, CONSIDER ANTERIOR INJURY TYPE 2 BRUGADA PATTERN [SADDLEBACK ST (...) . --There is also a saddleback in V2 and these are rarely due to STEMI. -- Sometimes LVH may be combined with early repolarization: high voltage and typical lateral leads on the one hand, but also right precordial leads that look like early repol with well-formed J-waves on the other hand. Here is an extensive discussion of the LVH pseudoSTEMI phenomenon: Can we use the early repolarization vs. LAD occlusion formula to help? In the setting of LVH, this often leads to false positives, but should not lead

2016 Dr Smith's ECG Blog

9. LAD occlusion or Early Repolarization?

LAD occlusion or Early Repolarization? Dr. Smith's ECG Blog: LAD occlusion or Early Repolarization? Tuesday, October 18, 2016 This male in his 20's presented with chest pain: There is sinus rhythm with a PVC. There is 2.5 mm ST elevation at the J-point, relative to the PQ junction, in both of leads V2, V3. This meets the ACC/AHA criteria (for age less than 40) for anterior STEMI. The ST segments in V2 and V3 are not upwardly concave (they are straight). Is it STEMI? Is it Early Repolarization (...) . For this ECG : Strictly speaking, the formula may not apply , as there is a straight ST segment in V2 and V3. Thus, if we had seen such an ECG in the LAD occlusion group, it would have been excluded as "obvious" STEMI, as early repolarization should have upwardly concave ST segments. Unfortunately, there are exceptions to this rule. Therefore, let's try to apply the rule. But be very careful with the result. If we do apply the formula, the numbers are: --QTc = 410 --STE60V3 = 4.0 --RAV4 = 18 Score = 23.1

2016 Dr Smith's ECG Blog

10. Anterior STEMI? Or Benign Early Repolarization?

Anterior STEMI? Or Benign Early Repolarization? Dr. Smith's ECG Blog: Anterior STEMI? Or Benign Early Repolarization? Friday, June 17, 2016 This was sent to me by Jason Winter, of Facebook Clinical Electrocardiology Page This is a 36 yo m with h/o TBI and epilepsy. He had a seizure this morning and rolled out of bed unable to get up. There were no injuries and no chest pain and he appeared well. He complained of 3 days of diarrhea and abdominal pain. The medics recorded a prehospital ECG (...) : The computerized QTc is 397 ms Jason writes: " What's your thoughts Steve?" Jason was very skeptical of STEMI. What do you think? Jason, I agree. V4 especially looks like early repolarization. There is high R-wave voltage. requires ST elevation at 60 ms after the J-point (here 5 mm), computerized QTc, and R-wave amplitude. Unfortunately, the R-wave is cut off on this ECG but it appears as if it would be at least 20 mm. This results in a value of 22.883. While one should be suspicious of any value greater than

2016 Dr Smith's ECG Blog

11. Relation of Early Repolarization (J Point Elevation) to Mortality in Blacks (from the Jackson Heart Study). (PubMed)

Relation of Early Repolarization (J Point Elevation) to Mortality in Blacks (from the Jackson Heart Study). Conflicting data exist regarding the associations of early repolarization (ER) with electrocardiogram (ECG) and clinical outcomes in blacks. We examined the association of ER defined by J point elevation (JPE) and all-cause mortality, and heart failure (HF) hospitalization in blacks in the Jackson Heart Study (JHS) cohort. We included JHS participants with ECGs from the baseline visit

2018 American Journal of Cardiology

12. Significance of Coronary Artery Spasm Diagnosis in Patients With Early Repolarization Syndrome (PubMed)

Significance of Coronary Artery Spasm Diagnosis in Patients With Early Repolarization Syndrome Previously described patients with early repolarization syndrome (ERS) may have experienced silent coronary artery spasm (CAS) because the diagnosis of CAS was mainly based on symptoms or coronary angiography findings, without performing a spasm provocation test. This study investigated the significance of CAS diagnosis and evaluated the incidence of silent CAS in patients with possible ERS (ie

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2018 Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

13. Recurrent ST segment elevations in a patient with asymptomatic early repolarization during head and neck surgery: implications of vasospastic angina (PubMed)

Recurrent ST segment elevations in a patient with asymptomatic early repolarization during head and neck surgery: implications of vasospastic angina A 57-year-old woman scheduled for cochlear implant removal exhibited preoperative electrocardiographic findings of early repolarization (ER). Four episodes of transient ST segment elevations during surgery raised suspicion for vasospastic angina (VA). In the post-anesthetic care unit, the patient complained of chest discomfort and received

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2018 Journal of Dental Anesthesia and Pain Medicine

14. Extreme example of early repolarization (PubMed)

Extreme example of early repolarization 29952366 2018 12 21 2149-2271 20 1 2018 Jul Anatolian journal of cardiology Anatol J Cardiol Extreme example of early repolarization. 61-63 10.14744/AnatolJCardiol.2018.14265 Altunbaş Gökhan G Department of Cardiology, Faculty of Medicine, Gaziantep University; Gaziantep-Turkey. drgokhanaltun@gmail.com. Vuruşkan Ertan E Sucu Murat M eng Journal Article Turkey Anatol J Cardiol 101652981 2149-2263 Anatol J Cardiol. 2018 Oct;20(4):252-253 30297588 2018 6 29

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2018 Anatolian journal of cardiology

15. SCN1Bβ mutations that affect their association with Kv4.3 underlie early repolarization syndrome (PubMed)

SCN1Bβ mutations that affect their association with Kv4.3 underlie early repolarization syndrome Abnormal cardiac ion channels current, including transient outward potassium current (Ito ), is associated with early repolarization syndrome (ERS). Previous studies showed that mutations in SCN1Bβ both to increase the Ito current and to decrease the sodium current. Yet its role in ERS remains unknown.To determine the role of mutations in the SCN1Bβ subunits in ERS.We screened for mutations

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2018 Journal of cellular and molecular medicine

16. The narrow-sense and common single nucleotide polymorphism heritability of early repolarization. (PubMed)

The narrow-sense and common single nucleotide polymorphism heritability of early repolarization. Early repolarization (ER) is a risk marker for sudden cardiac death. Higher risk is associated with horizontal/descending ST-segment ER in the inferior or inferolateral ECG leads. Studies in family cohorts have demonstrated substantial heritability for the ER pattern, but genome-wide association studies (GWAS) have failed to identify statistically significant and replicable genetic signals.We

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2018 International journal of cardiology

17. Epicardial Substrate as a Target for Radiofrequency Ablation in an Experimental Model of Early Repolarization Syndrome. (PubMed)

Epicardial Substrate as a Target for Radiofrequency Ablation in an Experimental Model of Early Repolarization Syndrome. Early repolarization syndrome (ERS) is an inherited cardiac arrhythmia syndrome associated with sudden cardiac death. Approaches to therapy are currently very limited. This study probes the mechanisms underlying the electrocardiographic and arrhythmic manifestation of experimental models of ERS and of the ameliorative effect of radiofrequency ablation.Action potentials (...) of the epicardium destroyed the cells displaying abnormal repolarization and thus suppressed the J waves and the development of ventricular tachycardia/ventricular fibrillation in 6/6 preparations.Our findings suggest that low-voltage fractionated electrical activity and high-frequency late potentials recorded from the epicardial surface of the left ventricle can identify regions of abnormal repolarization responsible for ventricular tachycardia/ventricular fibrillation in ERS and that radiofrequency ablation

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2018 Circulation. Arrhythmia and electrophysiology

18. VF Mapping in Brugada and Early Repolarization Syndromes

VF Mapping in Brugada and Early Repolarization Syndromes VF Mapping in Brugada and Early Repolarization Syndromes - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. VF Mapping in Brugada and Early (...) Research Institute Collaborator: University of Bordeaux Information provided by (Responsible Party): Koonlawee Nademanee, MD, Pacific Rim Electrophysiology Research Institute Study Details Study Description Go to Brief Summary: To determine the values and limitations of ECGI in guiding ablation and risk stratification in patients with BrS and Early Repolarization. Condition or disease Intervention/treatment Brugada Syndrome Early Repolarization Syndrome Other: radiofrequency ablation Detailed

2018 Clinical Trials

19. Early remodeling of repolarizing K<sup>+</sup> currents in the αMHC<sup>403/+</sup> mouse model of familial hypertrophic cardiomyopathy. (PubMed)

Early remodeling of repolarizing K+ currents in the αMHC403/+ mouse model of familial hypertrophic cardiomyopathy. Familial hypertrophic cardiomyopathy (HCM), linked to mutations in myosin, myosin-binding proteins and other sarcolemmal proteins, is associated with increased risk of life threatening ventricular arrhythmias, and a number of animal models have been developed to facilitate analysis of disease progression and mechanisms. In the experiments here, we use (...) the αMHC403/+ mouse line in which one αMHC allele harbors a common HCM mutation (in βMHC, Arg403 Gln). Here, we demonstrate marked prolongation of QT intervals in young adult (10-12week) male αMHC403/+ mice, well in advance of the onset of measurable left ventricular hypertrophy. Electrophysiological recordings from myocytes isolated from the interventricular septum of these animals revealed significantly (P<0.001) lower peak repolarizing voltage-gated K+ (Kv) current (IK,peak) amplitudes, compared

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2017 Journal of Molecular and Cellular Cardiology

20. A meta-analysis on the prognostic significance of inferolateral early repolarization pattern in Brugada syndrome. (PubMed)

A meta-analysis on the prognostic significance of inferolateral early repolarization pattern in Brugada syndrome. The early repolarization (ER) pattern has been linked to an increased risk for arrhythmic death in various clinical settings. There are limited and conflicting data regarding the prognostic significance of ER pattern in Brugada syndrome (BS). The aim of this meta-analysis was to provide a detailed analysis of the currently available studies regarding the arrhythmic risk in patients

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2017 Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

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