Early repolarization
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
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.
Definition
An example of early replzarization is shown in the figure at the top of the page. 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.[1]
Diagnosis
- Early repolarization is exacerbated by bradycardia, and carotid sinus massage may exacerbate the variant.
- The J point is frequently elevated (where the QRS joins the concave ST elevation).
Differentiating pericarditis from early repolarization:
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.
Prognosis of Early Repolarization and Association with VT/VF
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]
WikiDoc Research Resources for Early repolarization | |
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| Articles on Early repolarization | Most recent articles on Early repolarization • Most cited articles on Early repolarization • Review articles on Early repolarization • Articles on Early repolarization in N Eng J Med, Lancet, BMJ |
| Media (Slides, Video, Images, MP3) on Early repolarization | Powerpoint slides on Early repolarization • Images of Early repolarization • Photos of Early repolarization • Podcasts & MP3s on Early repolarization • Videos on Early repolarization |
| Evidence Based Medicine Regarding Early repolarization | AND (Cochrane Database Syst Rev[http://worldselectshop.com/?id=9361 Cochrane Collaboration on Early repolarization • Bandolier on Early repolarization • TRIP on Early repolarization |
| Cost Effectiveness of Early repolarization | AND (Cost effectiveness) |
| group5 = Clinical Trials Involving Early repolarization | list5 = Ongoing Trials on Early repolarization at Clinical Trials.gov • Trial results on Early repolarization • Clinical Trials on Early repolarization at Google
| group6 = Guidelines / Policies / Government Resources (FDA/CDC) Regarding Early repolarization
| list6 = US National Guidelines Clearinghouse on Early repolarization • NICE Guidance on Early repolarization • NHS PRODIGY Guidance • FDA on Early repolarization • CDC on Early repolarization
| group7 = Textbook Information on Early repolarization
| list7 = Books and Textbook Information on Early repolarization
| group8 = Pharmacology Resources on Early repolarization
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AND (Dose)}} Dosing of Early repolarization • AND (drug interactions)}} Drug interactions with Early repolarization • AND (side effects)}} Side effects of Early repolarization • AND (Allergy)}} Allergic reactions to Early repolarization • AND (overdose)}} Overdose information on Early repolarization • AND (carcinogenicity)}} Carcinogenicity information on Early repolarization • AND (pregnancy)}} Early repolarization in pregnancy • AND (pharmacokinetics)}} Pharmacokinetics of Early repolarization •
| group9 = Genetics, Pharmacogenomics, and Proteinomics of Early repolarization
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AND (pharmacogenomics)}} Genetics of Early repolarization • AND (pharmacogenomics)}} Pharmacogenomics of Early repolarization • AND (proteomics)}} Proteomics of Early repolarization
| group10 = Newstories on Early repolarization
| list10 = Early repolarization in the news • Be alerted to news on Early repolarization • News trends on Early repolarization</small>
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Blogs on Early repolarization
| group12 = Patient Resources on Early repolarization | list12 = Patient resources on Early repolarization • Discussion groups on Early repolarization • Patient Handouts on Early repolarization • Directions to Hospitals Treating Early repolarization • Risk calculators and risk factors for Early repolarization
| group13 = Healthcare Provider Resources on Early repolarization
| list13 =
Symptoms of Early repolarization • Causes & Risk Factors for Early repolarization • Diagnostic studies for Early repolarization • Treatment of Early repolarization
| group14 = Continuing Medical Education (CME) Programs on Early repolarization | list14 = CME Programs on Early repolarization
| group15 = International Resources on Early repolarization | list15 = Early repolarization en Espanol • Early repolarization en Francais
| group16 = Business Resources on Early repolarization | list16 = Early repolarization in the Marketplace • Patents on Early repolarization
| group17 = Informatics Resources on Early repolarization | list17 = List of terms related to Early repolarization
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