Early Repolarization: Difference between revisions

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A new and dynamic syndrome occurring in individuals with Idiopathic Ventricular Fibrillation or tachycardia due to genetic mutations affecting Phase 1 (Early Repolarization) of the action potential has been identified by Michel Haïssaguerre and his colleagues.
'''[[Early Repolarization]]''' is a term used for ST segment elevation without underlying disease. It probably has nothing to do with actual early repolarization. It is commonly seen in young men. It is important to discern early repolarization from ST segment elevation from other causes such as [[ischemia]]. Characteristics of early repolarization are:<cite>Kambara</cite>
 
* an upward concave elevation of the RS-T segment with distinct or "embryonic" J waves
Numerous cellular physiologists and researchers have contributed to our understanding of this syndrome. Recognition of this syndrome may help to prevent some of the sudden cardiac deaths in athletes and other individuals.
* slurred downstroke of R waves or distinct J points or both
* RS-T segment elevation commonly encountered in the precordial leads and more distinct in these leads
* rapid QRS transition in the precordial leads with counterclockwise rotation
* persistence of these characteristics for many years
* absence of reciprocal ST depression
* large symmetrical T waves
Recently early repolarization has also been used to describe late QRS notching or J wave slurring. When defined as such in the inferior leads (II, III en AVF) it has been found to be associated with an increased risk of cardiac death. Before screening for risk of sudden death by these new types of early repolarization can be perfomed a better definition is needed.


Before then, it has to overcome "growing pains" of being mis-named and the failure of Electrocardiographers to deal with R wave downslope phenomena (J waves, notches and slurs) prior to this time. When R wave downslope phenomena are present, we have to clarify the J-point definition as well as specify where end of the QRS complex and beginning of the ST segment occur.  
Before then, it has to overcome "growing pains" of being mis-named and the failure of Electrocardiographers to deal with R wave downslope phenomena (J waves, notches and slurs) prior to this time. When R wave downslope phenomena are present, we have to clarify the J-point definition as well as specify where end of the QRS complex and beginning of the ST segment occur.