Outcome of patients with early repolarization pattern and syncope
Tsukasa Kamakura1, Jean-Baptiste Gourraud2, Nicolas Clementy3
1Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.
Heart Rhythm
|April 8, 2022
Summary
Syncope with early repolarization (ER) pattern indicates higher risk for ventricular arrhythmias (VAs). Device implantation aids diagnosis, but traditional high-risk ECG markers did not predict VAs in this study.
Area of Science:
- Cardiology
- Electrophysiology
- Clinical Medicine
Background:
- Syncope in patients with early repolarization (ER) pattern is linked to increased risk of life-threatening ventricular arrhythmias (VAs).
- Accurate risk stratification and diagnosis in these patients remain challenging for clinicians.
Purpose of the Study:
- To analyze the clinical outcomes of patients experiencing syncope with an ER pattern.
- To identify predictive factors for the occurrence of VAs in this patient cohort.
Main Methods:
- A multicenter prospective registry enrolled 143 patients with ER pattern and syncope over 5 years.
- Electrocardiogram (ECG) monitoring devices were implanted in 97 patients, with 84 receiving implantable loop recorders.
- Follow-up averaged 68 months, documenting arrhythmias and recurrent syncope.
Main Results:
- Ventricular arrhythmias (VAs) occurred in 4.9% of patients over 5 years.
- The overall incidence of arrhythmic events causing syncope was 11.0%.
- No specific prodromes, triggers, family history, or previously identified high-risk ECG parameters differentiated patients who developed VAs.
Conclusions:
- Ventricular arrhythmias (VAs) occur in a small but significant percentage of patients with early repolarization (ER) pattern and syncope.
- Implanting monitoring devices guided by detailed patient history appears to be a rational diagnostic approach.
- Established high-risk ECG criteria did not effectively predict VAs in this population, highlighting the need for further research into risk stratification.
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