Ali Abdi, Butt Nida, Sheikh Azeem S
Abdi Ali, Nida Butt, Core Medical Trainees, Wrexham Maelor Hospital, Wrexham, Wales LL13 7TZ, United Kingdom.
World J Cardiol. 2015 Aug 26;7(8):466-75. doi: 10.4330/wjc.v7.i8.466.
Early repolarization syndrome (ERS), demonstrated as J-point elevation on an electrocardiograph, was formerly thought to be a benign entity, but the recent studies have demonstrated that it can be linked to a considerable risk of life - threatening arrhythmias and sudden cardiac death (SCD). Early repolarization characteristics associated with SCD include high - amplitude J-point elevation, horizontal and/or downslopping ST segments, and inferior and/or lateral leads location. The prevalence of ERS varies between 3% and 24%, depending on age, sex and J-point elevation (0.05 mV vs 0.1 mV) being the main determinants. ERS patients are sporadic and they are at a higher risk of having recurrent cardiac events. Implantable cardioverter-defibrillator implantation and isoproterenol are the suggested therapies in this set of patients. On the other hand, asymptomatic patients with ERS are common and have a better prognosis. The risk stratification in asymptomatic patients with ERS still remains a grey area. This review provides an outline of the up-to-date evidence associated with ERS and the risk of life - threatening arrhythmias. Further prospective studies are required to elucidate the mechanisms of ventricular arrhythmogenesis in patients with ERS.
早期复极综合征（ERS）在心电图上表现为J点抬高，以前被认为是一种良性情况，但最近的研究表明，它可能与发生危及生命的心律失常和心源性猝死（SCD）的相当大风险有关。与SCD相关的早期复极特征包括高振幅J点抬高、水平和/或下斜型ST段以及下壁和/或侧壁导联位置。ERS的患病率在3%至24%之间，取决于年龄、性别以及J点抬高（0.05 mV与0.1 mV），这是主要决定因素。ERS患者是散发性的，他们发生心脏事件复发的风险更高。植入式心脏复律除颤器植入和异丙肾上腺素是这组患者建议的治疗方法。另一方面，无症状的ERS患者很常见，且预后较好。无症状ERS患者的风险分层仍然是一个灰色地带。本综述概述了与ERS以及危及生命的心律失常风险相关的最新证据。需要进一步的前瞻性研究来阐明ERS患者室性心律失常发生的机制。
