Early Repolarization: When Is It a Normal Pattern?
Early repolarization (ER) is a common electrocardiographic pattern traditionally considered a benign finding. Recently, studies revealed an association between ER and an increased risk of arrhythmic death. Some clinical and electrocardiographic findings were evaluated with the aim to improve our ability to distinguish “benign” from “malignant early repolarization”. Widespread and high-amplitude J-point elevation followed by a horizontal or descending ST segment has been linked to arrhythmic mortality. Patients with early repolarization and frequent ventricular premature beats (VPBs), syncope or a family history of sudden cardiac death have also higher arrhythmic risks. However, none of these clinical or electrocardiographic findings per se is a valid stratification risk tool. We describe some case report that may enlight this issue.
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