TY - JOUR
T1 - Distinguishing "benign" from "malignant early repolarization"
T2 - The value of the ST-segment morphology
AU - Rosso, Raphael
AU - Glikson, Eran
AU - Belhassen, Bernard
AU - Katz, Amos
AU - Halkin, Amir
AU - Steinvil, Arie
AU - Viskin, Sami
PY - 2012/2
Y1 - 2012/2
N2 - Background: Means for distinguishing the very common "benign early repolarization" from the very rare but malignant form are needed. Recently, the presence of early repolarization with "horizontal ST segment" was found to predict arrhythmic death during long-term follow-up in a large population study. We therefore speculated that the combination of "J waves with horizontal ST segment" would correlate with a history of idiopathic ventricular fibrillation (VF) better than the mere presence of J waves. Objectives: To determine whether the morphology of the ST segment adds diagnostic value to the mere presence of J waves in a casecontrol series of idiopathic VF. Methods: We reanalyzed our casecontrol study showing that the presence of J waves strongly correlates with a history of idiopathic VF among 45 patients with this disorder, 124 controls matched for age and gender ("matched-control" group), and 121 young athletes. This time we focused only on those patients with J waves and graded their ST-segment morphology as either "horizontal" or "ascending" according to predefined criteria. Results: The presence of J waves was associated with a history of idiopathic VF with an odds ratio of 4.0 (95% confidence intervals = 2.07.9), but having both J waves and horizontal ST segment yielded an odds ratio of 13.8 (95% confidence intervals = 5.137.2) for having idiopathic VF. Conclusions: We report, for the first time, that the combination of J waves with horizontal/descending ST segment improved our ability to distinguish patients with idiopathic VF from controls matched by gender and age.
AB - Background: Means for distinguishing the very common "benign early repolarization" from the very rare but malignant form are needed. Recently, the presence of early repolarization with "horizontal ST segment" was found to predict arrhythmic death during long-term follow-up in a large population study. We therefore speculated that the combination of "J waves with horizontal ST segment" would correlate with a history of idiopathic ventricular fibrillation (VF) better than the mere presence of J waves. Objectives: To determine whether the morphology of the ST segment adds diagnostic value to the mere presence of J waves in a casecontrol series of idiopathic VF. Methods: We reanalyzed our casecontrol study showing that the presence of J waves strongly correlates with a history of idiopathic VF among 45 patients with this disorder, 124 controls matched for age and gender ("matched-control" group), and 121 young athletes. This time we focused only on those patients with J waves and graded their ST-segment morphology as either "horizontal" or "ascending" according to predefined criteria. Results: The presence of J waves was associated with a history of idiopathic VF with an odds ratio of 4.0 (95% confidence intervals = 2.07.9), but having both J waves and horizontal ST segment yielded an odds ratio of 13.8 (95% confidence intervals = 5.137.2) for having idiopathic VF. Conclusions: We report, for the first time, that the combination of J waves with horizontal/descending ST segment improved our ability to distinguish patients with idiopathic VF from controls matched by gender and age.
KW - Early repolarization
KW - Idiopathic ventricular fibrillation
KW - J waves
UR - http://www.scopus.com/inward/record.url?scp=84856175723&partnerID=8YFLogxK
U2 - 10.1016/j.hrthm.2011.09.012
DO - 10.1016/j.hrthm.2011.09.012
M3 - מאמר
AN - SCOPUS:84856175723
VL - 9
SP - 225
EP - 229
JO - Heart Rhythm
JF - Heart Rhythm
SN - 1547-5271
IS - 2
ER -