Heart Care Info - Heart Disease Prevention & Treatment

Prevalence and Characteristics of Early Repolarization in the CASPER Registry:: Cardiac Arrest Survivors With Preserved Ejection Fraction Registry

N Derval, CS Simpson, DH Birnie... - Journal of the American ..., 2011 - Elsevier OBJECTIVES: We evaluated the prevalence and characteristics of early repolarization in patients in CASPER (Cardiac Arrest Survivors With Preserved Ejection Fraction Registry). BACKGROUND: Early repolarization has been implicated in a syndrome of polymorphic ...

One hundred patients with apparently unexplained cardiac arrest and preserved ejection fraction underwent extensive clinical and genetic testing to unmask subclinical electrical or structural disease. A blinded independent analysis of the 12-lead electrocardiogram (ECG) was performed. Early repolarization was defined as ≥0.1 m V QRS-ST junction (J-point) elevation with terminal QRS slurring or notching in at least 2 contiguous inferior and/or lateral leads.

One hundred cardiac arrest patients were enrolled (40 females, age 43 14 years). Forty-four were diagnosed with an established cause for cardiac arrest. Significant early repolarization was found in 19 patients, including 6 with a primary diagnosis that explained their cardiac arrest (14%), compared with 23% of the 56 patients with idiopathic ventricular fibrillation (IVF) (p = 0.23). J-point elevation in IVF patients had higher amplitude (0.25 0.11 m V vs. 0.13 0.05 m V, p = 0.02) and wider distribution (4.3 1.3 leads vs. 2.8 0.8 leads; p = 0.01) than those with an established cause of cardiac arrest. J-wave amplitude was fluctuant on serial EC Gs; at least 1 ECG failed to demonstrate early repolarization in 58% of patients.