A clinical approach to early repolarization.

Abstract

The term early repolarization (ER) is defined electrocardiographically by either (1) a sharp well-defined positive deflection or notch immediately following a positive QRS complex at the onset of the ST-segment, or (2) slurring at the terminal part of the QRS complex (also termed J-waves or J-point elevation, Figure 1). Specifically, the ER pattern is present when J-point elevation of ≥0.1 mV is seen in 2 adjacent leads with either a slurred or notched morphology.1,2 Although ER was historically considered benign, this perception changed as numerous studies1–5 established an association with increased risk of death and idiopathic ventricular fibrillation (VF). The incidental discovery of early repolarization now poses numerous questions, including defining and quantitating the risk of sudden death.