J point elevation as a predictor of premature ventricular beats

Area of Science:

• Cardiology
• Electrophysiology
• Medical Diagnostics

Background:

• Early repolarization pattern (ERP) is a frequent electrocardiogram (ECG) finding.
• ERP is defined by J point elevation, QRS slurring/notching, ST elevation, and prominent T waves.
• The arrhythmogenic potential of ERP, particularly related to J point elevation severity, requires further investigation.

Purpose of the Study:

• To investigate the association between the degree of J point elevation in ERP and the occurrence of premature ventricular beats.
• To determine if a specific J point elevation threshold increases arrhythmogenicity.

Main Methods:

• Observational study including 36 patients (19-68 years) with ERP.
• Patients divided into two groups based on J point elevation: ≥0.15 mV (n=12) and <0.15 mV (n=24).
• 24-hour Holter monitoring was performed to quantify premature ventricular beats; no antiarrhythmic drugs were administered.

Main Results:

• The group with J point elevation ≥0.15 mV exhibited 27,432 premature ventricular beats.
• The group with J point elevation <0.15 mV showed 31,896 premature ventricular beats.
• A 1.72-fold higher number of premature ventricular beats was observed in the group with J point elevation ≥0.15 mV.

Conclusions:

• J point elevation of 0.15 mV or higher in ERP is associated with a significantly higher incidence of premature ventricular beats.
• This finding suggests that ERP with significant J point elevation is more arrhythmogenic.
• Elevated J point in ERP may serve as a marker for increased risk of ventricular arrhythmias.