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The early repolarization normal variant electrocardiogram: correlates and consequences.

Arthur L Klatsky1, Rudolph Oehm, Robert A Cooper

  • 1Department of Medicine, Kaiser Permanente Medical Care Program, Oakland, California 94611, USA. hartmavn@pacbell.net

The American Journal of Medicine
|August 26, 2003
PubMed
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Early repolarization on electrocardiograms (ECGs) is common in young, athletic men but has a benign long-term prognosis. This ECG pattern does not increase hospitalization or mortality risk compared to normal ECGs.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Preventive Medicine

Background:

  • Early repolarization (ER) is an electrocardiogram (ECG) finding observed in a subset of the population.
  • The clinical significance and long-term outcomes associated with ER compared to normal ECGs require further elucidation.

Purpose of the Study:

  • To compare the demographic characteristics and clinical outcomes of patients with early repolarization ECGs versus those with normal ECGs.
  • To determine if early repolarization is associated with increased risk of adverse cardiovascular events.

Main Methods:

  • A retrospective analysis of 2234 selected ECGs from 73088 health examinations conducted between 1983-1985.
  • ECGs were reinterpreted by cardiologists, categorizing them as early repolarization (n=670), borderline (n=330), or normal (n=1081).

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  • Statistical methods including analysis of variance, logistic regression, and proportional hazards models were used for comparison.

    • Main Results:

    • Patients with early repolarization were predominantly male (81%), younger than 40 (60%), black (48%), and more athletically active (10.4 hrs/week) compared to normal ECGs.
    • No increased likelihood of hospitalization (HR=1.0) or death (HR=0.8) was observed during follow-up for early repolarization.
    • Arrhythmias were less common in the early repolarization group (P<0.01).

    Conclusions:

    • Early repolarization is prevalent in young, athletic, black men but also occurs in other patient groups.
    • The long-term prognosis for individuals with early repolarization on ECG is benign.
    • Early repolarization is not associated with adverse cardiovascular outcomes or increased mortality.