Benign clinical significance of J-wave pattern (early repolarization) in highly trained athletes

Heart Rhythm

Volumn 11, Issue 11, 2014, Pages 1974-1982

  Quattrini, Filippo M ^a   Pelliccia, Antonio ^a   Assorgi, Riccardo ^a   DiPaolo, Fernando M ^a   Squeo, Maria Rosaria ^a   Culasso, Franco ^b   Castelli, Vincenzo ^c   Link, Mark S ^d   Maron, Barry J ^e  

^a Italian National Olympic Committee   (Italy)

^b SAPIENZA UNIVERSITY OF ROME   (Italy)

^c Giorgio Castelli Onluss Foundation   (Italy)

^d TUFTS MEDICAL CENTER   (United States)

^e MINNEAPOLIS HEART INSTITUTE FOUNDATION   (United States)

Author keywords

Arrhythmia; Athletes; Early repolarization; Electrocardiography; J wave; Sudden death

Indexed keywords

ADULT; ARTICLE; ATHLETE; ECHOCARDIOGRAPHY; ELECTRIC POTENTIAL; ELECTROCARDIOGRAM; ELECTROCARDIOGRAPHY; FEMALE; FOLLOW UP; HEART LEFT VENTRICLE; HEART REPOLARIZATION; HEART SIZE; HUMAN; J WAVE; MALE; NORMAL HUMAN; PREVALENCE; PRIORITY JOURNAL; QRS COMPLEX; SPORT; ST SEGMENT ELEVATION; ADOLESCENT; ECHOGRAPHY; HEART MUSCLE CONDUCTION SYSTEM; HEART VENTRICLE FIBRILLATION; ITALY; MIDDLE AGED; PATHOPHYSIOLOGY; RISK ASSESSMENT; RISK FACTOR; SUDDEN CARDIAC DEATH;

ADOLESCENT; ADULT; ATHLETES; DEATH, SUDDEN, CARDIAC; ECHOCARDIOGRAPHY; ELECTROCARDIOGRAPHY; FEMALE; HEART CONDUCTION SYSTEM; HUMANS; ITALY; MALE; MIDDLE AGED; PREVALENCE; RISK ASSESSMENT; RISK FACTORS; VENTRICULAR FIBRILLATION;

EID: 84930405728     PISSN: 15475271     EISSN: 15563871     Source Type: Journal    
DOI: 10.1016/j.hrthm.2014.07.042     Document Type: Article

References (35)

1. Maron, B.J., Doerer, J.J., Haas, T.S., Tierney, D.M., Mueller, F.O., Sudden death in young competitive athletes: analysis of 1866 deaths in the Unites states, 1980–2006. Circulation 119 (2009), 1085–1092.
2. Corrado, D., Pelliccia, A., Bjornstad, H.H., et al. Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Eur Heart J 26 (2005), 516–524.
3. Ljungqvist, A., Jenoure, P., Engebretsen, L., et al. The International Olympic Committee (IOC) Consensus Statement on periodic health evaluation of elite athletes March 2009. Br J Sports Med 43 (2009), 631–643.
4. Dvorak, J., Grimm, K., Schmied, C., Junge, A., Development and implementation of a standardized precompetition medical assessment of international elite football players—2006 FIFA World Cup Germany. Clin J Sport Med 19 (2009), 316–321.
5. Pelliccia, A., Maron, B.J., Culasso, F., Di Paolo, F.M., Spataro, A., Biffi, A., Caselli, G., Piovano, P., Clinical significance of abnormal electrocardiographic patterns in trained athletes. Circulation 102 (2000), 278–284.
6. Pelliccia, A., Culasso, F., Di Paolo, F., et al. Prevalence of abnormal electrocardiograms in a large, unselected population undergoing pre-participation cardiovascular screening. Eur Heart J 28 (2007), 2006–2010.
7. Corrado, D., Pelliccia, A., Heidbuchel, H., et al. Recommendations for interpretation of 12-lead electrocardiogram in the athlete. Eur Heart J 31 (2010), 243–259.
8. Gussak, I., Antzelevitch, C., Early repolarization syndrome: clinical characteristic and possible cellular and ionic mechanisms. J Electrocardiol 33 (2000), 299–309.
9. Takagi, M., Aihara, N., Takaki, H., Taguchi, A., Shimizu, W., Kurita, T., Suyama, K., Kamakura, S., Clinical characteristics of patients with spontaneous or inducible ventricular fibrillation without apparent heart disease presenting with J wave and ST segment elevation in inferior leads. J Cardiovasc Electrophysiol 11 (2000), 844–848.
10. Antzelevitch, C., Yan, G.X., J wave syndromes. Heart Rhythm 7 (2010), 549–558.
11. Haissaguerre, M., Derval, N., Sacher, F., et al. Sudden cardiac arrest associated with early repolarization. N Engl J Med 358 (2008), 2016–2023.
12. Rosso, R., Kogan, E., Belhassen, B., Rozovski, U., Scheinman, M.M., Zeltser, D., Halkin, A., Steinvil, A., Heller, K., Glikson, M., Katz, A., Viskin, S., J-point elevation in survivors of primary ventricular fibrillation and matched control subjects. J Am Coll Cardiol 52 (2008), 1231–1238.
13. Tikkanen, J.T., Anttonen, O., Junttila, M.J., Aro, A.L., Kerola, T., Rissanen, H.A., Reunanen, A., Huikuri, H.V., Long-term outcome associated with early repolarization on electrocardiography. N Engl J Med 361 (2009), 2529–2537.
14. Sinner, M.F., Reinhard, W., Muller, M., et al. Association of early repolarization pattern on ECG with risk of cardiac and all-cause mortality: a population-based prospective cohort study (MONICA/KORA). PLoS Med, 7, 2010, e1000314.
15. Merchant, F.M., Noseworthy, P.A., Weiner, R.B., Singh, S.M., Ruskin, J.N., Reddy, V.Y., Ability of terminal QRS notching to distinguish benign from malignant electrocardiographic forms of early repolarization. Am J Cardiol 104 (2009), 402–406.
16. Miyazaki, S., Shah, A., Haissaguerre, M., Early repolarization syndrome: a new electrical disorder associated with sudden death. Circ J 74 (2010), 2039–2044.
17. Haruta, D., Matsuo, K., Tsuneto, A., Ichimaru, S., Hida, A., Sera, N., Imaizumi, M., Nakashima, E., Maemura, K., Akahoshi, M., Incidence and prognostic value of early repolarization pattern in the 12-lead electrocardiogram. Circulation 123 (2011), 2931–2937.
18. Rosso, R., Adler, A., Halkin, A., Viskin, S., Risk of sudden death among young individuals with J waves and early repolarization: putting the evidence into perspective. Heart Rhythm 8 (2011), 923–929.
19. Junttila, M.J., Sager, S.J., Tikkanen, J.T., Anttonem, O., Huikuri, H.V., Myerburg, R.J., Clinical significance of variations of J-points and J-waves: early repolarization patterns and risk. Eur Heart J 33 (2012), 2639–2644.
20. Noseworthy, P.A., Weiner, R., Kim, J., Keelara, V., Wang, F., Berkstresser, B., Wood, M.J., Wang, T.J., Picard, M.H., Hutter, A.M. Jr, Newton-Cheh, C., Baggish, A.L., Early repolarization pattern in competitive athletes: clinical correlates and the effects of exercise training. Circ Arrhythm Electrophysiol 4 (2011), 432–440.
21. Muramoto, D., Yong, C.M., Singh, N., Aggarwal, S., Perez, M., Ashley, E., Hadley, D., Froelicher, V., Patterns and prognosis of all components of the J-wave pattern in multi-ethnic athletes and ambulatory patients. Am Heart J 167 (2014), 259–266.
22. Noseworthy, P.A., Baggish, A.L., The prevalence and clinical significance of J wave patterns in athletes. J Electrocardiol 46 (2013), 424–426.
23. Pérez-Riera, A.R., Abreu, L.C., Yanowitz, F., Barros, R.B., Femenía, F., McIntyre, W.F., Baranchuk, A., Benign early repolarization versus malignant early abnormalities: clinical-electrocardiographic distinction and genetic basis. Cardiol J 19 (2012), 337–346.
24. Pelliccia, A., Fagard, R., Bjornstad, H.H., et al. Recommendations for competitive sports participation in athletes with cardiovascular disease: a consensus document. Eur Heart J 26 (2005), 1422–1445.
25. Kligfield, P., Gettes, L.S., Bailey, J.J., Childers, R., Deal, B.J., Hancock, E.W., van Herpen, G., Kors, J.A., Macfarlane, P., Mirvis, D.M., Pahlm, O., Rautaharju, P., Wagner, G.S., Recommendations for the standardization and interpretation of the electrocardiogram: part I. Circulation 115 (2007), 1306–1324.
26. Lang, R.M., Bierig, M., Devereux, R.B., et al. American Society of Echocardiography's Nomenclature and Standards Committee. Recommendations for chamber quantification. Eur J Echocardiogr 7 (2006), 79–108.
27. Nagueh, S.F., Appleton, C.P., Gillebert, T.C., Marino, P.N., Oh, J.K., Smiseth, O.A., Waggoner, A.D., Flachskampf, F.A., Pellikka, P.A., Evangelista, A., Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J Am Soc Echocardiogr 22 (2009), 107–133.
28. Biffi, A., Maron, B.J., Culasso, F., Verdile, L., Fernando, F., Di Giacinto, B., Di Paolo, F.M., Spataro, A., Delise, P., Pelliccia, A., Patterns of ventricular tachyarrhythmias associated with training, deconditioning and retraining in elite athletes without cardiovascular abnormalities. Am J Cardiol 107 (2011), 697–703.
29. Shipley, R.A., Hallaran, W.R., The four-lead electrocardiogram in 200 normal men and women. Am Heart J 11 (1936), 325–345.
30. Wasserburger, R.H., Alt, W.J., The normal RS-T segment elevation variant. Am J Cardiol 8 (1961), 184–192.
31. Klatsky, A.L., Oehm, R., Cooper, R.A., Udaltsova, N., Armstrong, M.A., The early repolarization normal variant electrocardiogram: correlates and consequences. Am J Med 115 (2003), 171–177.
32. Tikkanen, J.T., Junttila, M.J., Anttonen, O., Aro, A.L., Luttinen, S., Kerola, T., Sager, S.J., Rissanen, H.A., Myerburg, R.J., Reunanen, A., Huikuri, H.V., Early repolarization: electrocardiographic phenotypes associated with favorable long-term outcome. Circulation 123 (2011), 2666–2673.
33. Noseworthy, P.A., Tikkanen, J.T., Porthan, K., et al. The early repolarization pattern in the general population: clinical correlates and heritability. J Am Coll Cardiol 57 (2011), 2284–2289.
34. Kalla, H., Yan, G.X., Marinchak, R., Ventricular fibrillation in a patient with prominent J (Osborn) waves and ST-segment elevation in the inferior electrocardiographic leads: a Brugada syndrome variant?. J Cardiovasc Electrophysiol 11 (2000), 95–98.
35. Maron, B.J., Pelliccia, A., The heart of trained athletes: cardiac remodeling and the risks of sports, including sudden death. Circulation 114 (2006), 1633–1644.