Seven years follow-up of early repolarisation patterns in French elite special forces

The early repolarization pattern (ERP) may be a marker of increased risk for sudden cardiac death (SCD). Influence of ethnicity on the ERP has not been extensively studied. The aim of this study was to evaluate the epidemiology of ERP in a male multiethnic population.

ECG analysis was performed among consecutive recruits from the French Foreign Legion. ERP was characterized by a J-point elevation ≥0.1 mV in two continuous inferior-lateral leads, and high amplitude early repolarization (HAER-potentially malignant pattern) by an elevation ≥0.2 mV. Ethnical affiliation and level of physical activity were recorded.

A total of 2508 healthy men (24 ± 5 years old) from 105 different native countries were divided into three ethnic groups: 1689 Whites, 388 Afro-Caribbean, and 431 Asians. ERP was found in 489 recruits (19%), 14% in Whites, 33% in Afro-Caribbeans, and 27% in Asians without any difference according to age and physical activity. Sub-Saharan Africans or Caribbeans had the highest rate of ERP (30%), and Hispanics the lowest (8%). People from occidental countries, Middle East, Central Asia or India had a rate of 12%-18%, East and South-Asia 20%-25%. Madagascar was an exception with only 16% of ERP. HAER (2.9%) was more frequent among Asian recruits. After 5 ± 2 years of follow up, one SCD occurred in the ERP group (p = 0.042).

This study reports a large multiethnic analysis of ERP. HAER was more frequent in recruits from East and South-East Asia where sudden unexplained nocturnal death syndrome is endemic.