Early Repolarization Pattern (ERP)

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Introduction

Early repolarization pattern (ERP) is an enigmatic common electrocardiographic (ECG) finding,occurring in 1% to 2% of the general population (1). ERP prevalence is decreasing with advancing age (2) This ECG pattern is frequently observed in healthy persons,particularly young,male (3,4,5), athletic (6,7), and of African-American origin (4,5,6,7,8).On the 12-lead ECG the ERP is characterized as “notching” or “slurring” of the terminal portion of the R wave and beginning of the ST-segment that produces a positive hump known as J wave. The J wave is a deflection with a dome that appears immediately after the end of QRS complex followed by ST-segment elevation ≥ 0.1 mV (or 1 mm, varying from 1 to 4 mm) above isoelectric line (relative to the subsequent TP interval) concave upward in at least two contiguous ECG leads. This ECG finding is most frequently seen in the precordial leads from V3 to V5 and often in the inferior leads II, III, and aVF (9)
Normal ERP should be differentiated from others conditions with ST segment elevation such as asthenic habitus, acute pericarditis, STEMI,Brugada syndrome (BrS), congenital short QT syndrome(SQTS), and IVF (10,11).
Although the condition is usually considered benign, its potential arrhythmogenicity has been suggested by experimental studies.(12)
The majority of such sudden cardiac arrests are caused by ventricular tachyarrhythmias, which occur in persons without structural heart disease in 6 to 14% of cases. (13,14)
These results were replicated in similar studies and the association with increased arrhythmic risk was subsequently extended to the general population in large cohort studies (16,17).
In brief, ER consists of 2 components: prominent J waves and ST-segment elevation....

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... and QT interval association.In the recently study, patients with ERP had shorter QTc interval than subjects with normal ECG pattern. Also statistical results are significantly different about other paratemeters like QT,JT,JTc,QT-apex interval.The previous studies showed ERP and short QT interval relation however subjects had different heart rates.Conversely we showed this association one-to-one matching with heart rates.

Study limitations
The number of subjects in this study is limited,because as a tertiary center patients with early repolarization pattern referred to our institution were complex and had comorbidities
Although the cohort included subjects with strictly defined common features, data collectionwas not uniform among centers. In our study population, we had no subjects with structural heart disease so the results may not apply to these subgroups.

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