Author + information
- David Muramoto,
- Nikhil Singh,
- Sonya Aggarwal,
- Marco Perez,
- Euan Ashley,
- David Hadley and
- Victor Froelicher
Despite recent concern for early repolarization (ER) and screening in young athletes, limited data describe all components (QRS slurs, J waves, and ST elevation) of ER in ambulatory clinical populations and athletes.
We retrospectively studied 5,085 ECGs from a stable, multi-ethnic clinical population from 1997 to 1999 at the Veterans Affairs Palo Alto Health Care System, analyzing 4,041 after excluding those with atrial fibrillation, prolonged QRS, and acute myocardial infarction. During screening of Stanford University varsity athletes in 2007 and 2008, 1,114 ECGs were obtained. Using the PR interval as the isoelectric line and an amplitude criterion of >1 mm, ST elevation was defined from QRS-end and J waves and slurs defined as upward deflections and conduction delays on the R wave downslope, respectively. In clinical subjects, prognosis was assessed using the primary endpoint of time to cardiovascular mortality.
Components of ER occurred most frequently in males, African Americans, and athletes, with the most marked differences noted in the lateral leads. No component of ER was associated with age-adjusted risk of cardiovascular death.
Significant differences in the prevalence of ER exist based on gender, race, and athletic status, and must be considered when interpreting ECGs in apparently healthy adults and during athletic screening. This large sample also provides a control group for future comparisons with patients with conditions with arrhythmic risk.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Arrhythmias: Sudden Cardiac Death – Mechanisms and Treatment Strategies
Abstract Category: 6. Arrhythmias: Other
Presentation Number: 1192-57
- 2013 American College of Cardiology Foundation