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The early repolarization variant--normal or a marker of heart disease in certain subjects

John P Boineau1

  • 1Division of Cardiology, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA. schuesslerd@wustl.edu

Journal of Electrocardiology
|November 4, 2006
PubMed

Insights

Early repolarization variant may be a substrate for dangerous heart conditions like sudden death and arrhythmias, not always benign. This cardiovascular anomaly may share genetic origins with Brugada syndrome.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Genetics

Background:

  • Early repolarization variant (ERV) is often considered a benign finding on electrocardiograms.
  • However, recent observations suggest a potential association with adverse cardiac events.

Purpose of the Study:

  • To investigate the potential arrhythmogenic substrate of the early repolarization variant.
  • To explore its relationship with other nonischemic ST-elevation syndromes and its possible genetic basis.

Main Methods:

  • Theoretical advancement and synthesis of existing clinical and genetic data.
  • Comparative analysis with Brugada syndrome and other cardiovascular anomalies.

Main Results:

  • The early repolarization variant may not always be benign.
  • It can serve as a substrate for ventricular arrhythmias, sudden death, and hypercontractility cardiomyopathy, particularly in athletes.
  • ERV may represent part of a spectrum of cardiovascular anomalies linked to nonischemic ST elevation.

Conclusions:

  • The early repolarization variant warrants further investigation as a potential risk factor for sudden cardiac death.
  • A molecular genetic origin with variable penetrance is suggested for ERV.
  • ERV may be related to Brugada syndrome and other nonischemic ST-elevation conditions.

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