Cited by 282Cardiac electrophysiology and arrhythmiasCardiovascular Effects of ExerciseCardiac Health and Mental Health

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Association of Early Repolarization Pattern on ECG with Risk of Cardiac and All-Cause Mortality: A Population-Based Prospective Cohort Study (MONICA/KORA)

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Sinner, Moritz F., Reinhard, Wibke, Müller, Martina, Beckmann, Britt-Maria, Martens, Eimo, Perz, Siegfried, Pfeufer, Arne, Winogradow, Janina, Stark, Klaus, Meisinger, Christa, Wichmann, H.-Erich, Peters, Annette, Riegger, Günter A. J., Steinbeck, Gerhard, Hengstenberg, Christian, Kääb, Stefan·2010·PLoS Medicine

DOI 10.1371/journal.pmed.1000314PMC PMC2910598

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Abstract

BACKGROUND: Early repolarization pattern (ERP) on electrocardiogram was associated with idiopathic ventricular fibrillation and sudden cardiac arrest in a case-control study and with cardiovascular mortality in a Finnish community-based sample. We sought to determine ERP prevalence and its association with cardiac and all-cause mortality in a large, prospective, population-based case-cohort study (Monitoring of Cardiovascular Diseases and Conditions [MONICA]/KORA [Cooperative Health Research in the Region of Augsburg]) comprised of individuals of Central-European descent. METHODS AND FINDINGS: Electrocardiograms of 1,945 participants aged 35-74 y, representing a source population of 6,213 individuals, were analyzed applying a case-cohort design. Mean follow-up was 18.9 y. Cause of death was ascertained by the 9th revision of the International Classification of Disease (ICD-9) codes as documented in death certificates. ERP-attributable effects on mortality were determined by a weighted Cox proportional hazard model adjusted for covariables. Prevalence of ERP was 13.1% in our study. ERP was associated with cardiac and all-cause mortality, most pronounced in those of younger age and male sex; a clear ERP-age interaction was detected (p = 0.005). Age-stratified analyses showed hazard ratios (HRs) for cardiac mortality of 1.96 (95% confidence interval [CI] 1.05-3.68, p = 0.035) for both sexes and 2.65 (95% CI 1.21-5.83, p = 0.015) for men between 35-54 y. An inferior localization of ERP further increased ERP-attributable cardiac mortality to HRs of 3.15 (95% CI 1.58-6.28, p = 0.001) for both sexes and to 4.27 (95% CI 1.90-9.61, p<0.001) for men between 35-54 y. HRs for all-cause mortality were weaker but reached significance. CONCLUSIONS: We found a high prevalence of ERP in our population-based cohort of middle-aged individuals. ERP was associated with about a 2- to 4-fold increased risk of cardiac mortality in individuals between 35 and 54 y. An inferior localization of ERP was associated with a particularly increased risk. Please see later in the article for the Editors' Summary.

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BackgroundResultInfluential
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“Subsequently, the community epidemiological studies reported that J waves or slurring, particularly in the inferior leads, had an adjusted hazard of 2 to 4 for cardiac death.(3,6) These studies were contrary to the previously upheld notion that ER was benign.”
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“(1,2) Infero-lateral early repolarization ECG pattern, have also been demonstrated to be associated with an increased risk of sudden cardiac death (SCD) and mortality in general population (3-5).”
Background
Prevalence and impact on outcome of electrocardiographic early repolarization patterns among stroke patients: a prospective observational study
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“Patients with implanted pacemaker, significant ventricular conduction delay (QRS[120 ms) as well as atrial fibrillation were excluded from analysis [21, 22].”
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J Wave Syndromes: History and Current Controversies
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Six-Year Outcome of Subjects Without Overt Heart Disease With an Early Repolarization/J Wave Electrocardiographic Pattern
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J-Wave Syndromes
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Presence of early repolarization on admission electrocardiography is associated with long-term mortality and MACE in patients with STEMI undergoing primary percutaneous intervention
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“Four high-risk subtypes of ER have been identified which are associated with a worse outcome including a high ER amplitude (> 2 mV), in particular in the inferior leads [4, 7], a notching morphology [8] and a horizontal/descending ST-segment [9].”
Self-citation
Early repolarization in adolescent athletes: A gender comparison of ECG and echocardiographic characteristics
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Prevalence of early repolarization syndrome and long-term clinical outcome in patients with the diagnosis of idiopathic ventricular fibrillation
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Early repolarisation among athletes
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“1 mV), has been described as being associated with an increased risk for arrhythmias.(20) As mentioned above, a J-point elevation of at least of 0.”
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Acute Cardiac Complications in Critical Brain Disease
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The effect of exercise on the ECG criteria for early repolarization pattern
Nouraei, H., & Rabkin, S. W. (2019) · Journal of Electrocardiology · doi:10.1016/j.jelectrocard.2019.03.005 · Cited by 10
J wave syndromes in patients with spinal and bulbar muscular atrophy
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Notching early repolarization pattern in inferior leads increases risk of ventricular tachyarrhythmias in patients with acute myocardial infarction: a meta-analysis
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ECG repolarization syndrome abnormalities (J wave syndromes) and idiopathic ventricular fibrillation
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“The report of Sinner et al. [ 15 ] on a German based-population found that cardiac mortality was increased for both sexes in subjects with ER pattern but that men between 35 and 54 years had an increased “ER pattern attributable” cardiac mortality risk.”
BackgroundInfluential
Relationship between J Waves and Vagal Activity in Patients Who Do Not Have Structural Heart Disease
Baek, Y., Park, S., Lee, M., Kwon, S., Shin, S., Woo, S., Kwan, J., & Kim, D. (2015) · Annals of Noninvasive Electrocardiology · doi:10.1111/anec.12302 · Cited by 9
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Malhi, N., So, P. P., Cheung, C. C., Laksman, Z., Healey, J. S., Chauhan, V. S., Green, M. S., Champagne, J., Steinberg, C., Sanatani, S., et al. (2018) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2018.07.001 · Cited by 9
“This is supported by the sporadic nature of ER, and its “ambient” prevalence in the general population (2,7,10,18,22).”
Background
Quantitative Assessment of the Effects of Therapeutic Hypothermia on Early Repolarization in Idiopathic Ventricular Fibrillation Survivors
Williams, S. E., Sabir, I. N., Nimmo, C., Linton, N., Sebag, F. A., Harrison, J. L., Wright, M. J., Barrett, N. A., Shankar‐Hari, M., & O'Neill, M. D. (2014) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.113.000555 · Cited by 8
“120 Early repolarization (ER) is a common electrocardiographic finding, being seen in 5% to 13% of Europeans.(1,2) Although long thought to be a benign variant or even a marker of cardiovascular health,(3,4) robust data now point to such changes as a marker of elevated risk of ventricular fibrillation (VF) and cardiac…”
Background
Evaluation of left ventricular myocardial deformation parameters in individuals with electrocardiographic early repolarization pattern
Gülel, O. (2016) · The Anatolian Journal of Cardiology · doi:10.14744/anatoljcardiol.2016.6912 · Cited by 8
“Additionally, there is an increased risk of experiencing syncope or sudden cardiac arrest if idiopathic ventricular fibrillation patients have ER pattern in their electrocardiographies (2, 3).”
Background
Early Repolarization Pattern Predicts the Increased Risk of Ventricular Arrhythmias in Patients With Acute Anterior ST-Segment Elevation Myocardial Infarction ― A Propensity Analysis ―
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“The early repolarization pattern (ERP), manifested as elevation of the QRS-ST junction (J-point) affecting 1% to 13% of general population, has been traditionally considered a benign entity.(1) Nevertheless, more recent studies have shown positive, negative, and neutral relationships between ERP and cardiovascular out…”
Background
Prevalence and Correlates of Electrocardiographic Abnormalities in Adults With HIV: Insights From the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE)
Bloomfield, G. S., Weir, I. R., Ribaudo, H. J., Fitch, K. V., Fichtenbaum, C. J., Moran, L. E., Bedimo, R., de Filippi, C., Morse, C. G., Piccini, J. P., et al. (2021) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000002877 · Cited by 8
Early repolarization in the inferolateral leads of the electrocardiogram : prevalence, prognosis and characteristics
Tikkanen, J. T. (2013) · Cited by 7
Clinical significance of J-wave in elite athletes
Pelliccia, A., & Quattrini, F. M. (2015) · Journal of Electrocardiology · doi:10.1016/j.jelectrocard.2015.03.012 · Cited by 7
“At present time, the available scientific evidence (either case–control and population based studies) supports the concept that patients with history of idiopathic VF show an increased prevalence of ER pattern, particularly in the inferior and inferior–lateral leads, thus confirming a link between this ECG alteration…”
BackgroundResult
Prevalence and characteristics of idiopathic right ventricular outflow tract arrhythmias associated with J-waves
Yamashina, Y., Yagi, T., Namekawa, A., Ishida, A., Sato, H., Nakagawa, T., Sakuramoto, M., Sato, E., & Yambe, T. (2011) · EP Europace · doi:10.1093/europace/eur256 · Cited by 7
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Tikkanen, J. T., & Huikuri, H. V. (2013) · Journal of Electrocardiology · doi:10.1016/j.jelectrocard.2013.06.012 · Cited by 7
The prevalence of the electrocardiographic J wave in the Petit Basset Griffon Vendéen compared to 10 different dog breeds
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Prevalence of early repolarisation pattern in children
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“Our single‐center retrospective study demonstrated a higher preva‐ lence of ERPs with malignant characteristics (downsloping‐hori‐ zontal ST segment, dominantly infero‐lateral distribution) in our AF population than were observed in other similar western community‐ based population cohorts demonstrating prevalences be…”
BackgroundResultInfluential
For Whom the Bell Tolls
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Mechanisms of Cardiac Arrhythmia
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Why Is There an Increased Risk for Sudden Cardiac Death in Patients With Early Repolarization Syndrome?
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Prevalence of Early Repolarization Patterns in a French Military Population at Low Cardiovascular Risk: Implications for Preventive Medicine
Vinsonneau, U., Pinon, B., Paleiron, N., Rohel, G., Piquemal, M., Désidéri‐Vaillant, C., Castellant, P., Abaléa, J., Valls-Bertault, V., Carré, F., et al. (2013) · Annals of Noninvasive Electrocardiology · doi:10.1111/anec.12057 · Cited by 6
Natural History of Early Repolarization in the Inferior Leads
Stein, R., Sallam, K., Adhikarla, C., Boga, M., Wood, A. D., & Froelicher, V. F. (2012) · Annals of Noninvasive Electrocardiology · doi:10.1111/j.1542-474x.2012.00537.x · Cited by 6
Early repolarization is associated with significant coronary artery stenosis in asymptomatic adults
Suh, B., Park, S., Shin, D. W., Ahn, H., Cho, S., Lee, S., Park, E., Lee, H.-J., Park, J., & Cho, B. (2015) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2015.11.026 · Cited by 6
Ventricular and Supraventricular Ectopy in Subjects With Early Repolarization.
Trenkwalder, T., King, R., Kaess, B., Hengstenberg, C., Schunkert, H., Ittermann, T., Felix, S., Busch, M. C., Dörr, M., & Reinhard, W. (2017) · American Journal of Cardiology · doi:10.1016/j.amjcard.2017.03.254 · Cited by 6
“254 leads as a possible high-risk subphenotype.(1) In addition, Tikkanen et al(8) differentiated between a “benign” variant with a rapidly ascending ST-segment and a potentially “malignant” form with a horizontal/descending ST-segment morphology following the J-point elevation.”
BackgroundResultSelf-citation
Prevalence of early repolarization pattern in patients with lone atrial fibrillation
McNair, P. W., Benenson, D. M., Ip, J. E., Thomas, G. R., Cheung, J. W., Liu, C. F., Lerman, B. B., & Markowitz, S. M. (2017) · Journal of Electrocardiology · doi:10.1016/j.jelectrocard.2017.04.020 · Cited by 6
Epidemiology in Germany—general development and personal experience
Wichmann, H. ‐. (2017) · European Journal of Epidemiology · doi:10.1007/s10654-017-0290-7 · Cited by 6
Self-citation
Electrocardiographic early repolarization is associated with future ventricular arrhythmia after acute myocardial infarction—Systematic Review and Meta‐Analysis
Pranata, R., Yonas, E., Vania, R., Raharjo, S. B., Siswanto, B. B., & Setianto, B. (2019) · Journal of Arrhythmia · doi:10.1002/joa3.12196 · Cited by 6
A novel DPP6 variant in Chinese families causes early repolarization syndrome
Ji, C., Yao, F., Cheng, Y., Yao, H., Fan, J., Chen, X., Zheng, Z., Dong, Y., & Wu, S. (2019) · Experimental Cell Research · doi:10.1016/j.yexcr.2019.111561 · Cited by 6
Evaluation Of Patients With Early Repolarization Syndrome.
Mahida, S., Sacher, F., Berte, B., Yamashita, S., Lim, H. S., Derval, N., Denis, A., Shah, A. J., Amraoui, S., Hocini, M., et al. (2014) · Europe PMC (PubMed Central) · doi:10.4022/jafib.1083 · Cited by 6
Seven years follow‐up of early repolarisation patterns in French elite special forces
Roche, N., Massoure, P., Deharo, J., Paule, P., & Fourcade, L. (2018) · Annals of Noninvasive Electrocardiology · doi:10.1111/anec.12560 · Cited by 6
Early Repolarization Redux: The Devil Is in the Methods
Froelicher, V. F. (2012) · Annals of Noninvasive Electrocardiology · doi:10.1111/j.1542-474x.2011.00483.x · Cited by 6
Ion Channel Diseases: an Update for 2016
Tomaselli, G. F., & Barth, A. S. (2016) · Current Treatment Options in Cardiovascular Medicine · doi:10.1007/s11936-016-0442-1 · Cited by 5
J wave patterns and ST elevation in women
Yong, C. M., Zarafshar, S., & Froelicher, V. F. (2013) · Journal of Electrocardiology · doi:10.1016/j.jelectrocard.2013.06.027 · Cited by 5
Early Repolarisation – What Should the Clinician Do?
Obeyesekere, M., Krahn, A. D., & Cabrini and Epworth Healthcare Groups, V. (2015) · Arrhythmia & Electrophysiology Review · doi:10.15420/aer.2015.04.02.96 · Cited by 5
Cardiac Morphofunctional Characteristics of Individuals with Early Repolarization Pattern: A Literature Review
Kocsis, L., Pap, Z., & Frigy, A. (2022) · Journal of Cardiovascular Development and Disease · doi:10.3390/jcdd10010004 · Cited by 5
“These results were confirmed later by several other studies of subjects who died from different cardiovascular diseases [18,19,21].”
The relationship between J waves and contact of lung cancer with the heart
Hayashi, H., Wu, Q., & Horie, M. (2017) · Annals of Noninvasive Electrocardiology · doi:10.1111/anec.12433 · Cited by 5
“We do not know the reason exactly; but, a possible explanation is that the follow- up period of this study was too short as compared to previous studies (Haissaguerre et al., 2008; Olson, Viera, Soliman, Crow, & Rosamond, 2011; Rollin et al., 2012; Sinner et al., 2010; Tikkanen et al., 2009).”
PREVALENCE AND CHARACTERISTICS OF IDIOPATHIC RIGHT VENTRICULAR OUTFLOW TRACT ARRHYTHMIAS ASSOCIATED WITH J WAVES
Yamashina, Y., Yagi, T., Namekawa, A., Ishida, A., Sato, H., Nakagawa, T., Sakuramoto, M., Sato, E., & Yambe, T. (2011) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(11)60074-0 · Cited by 5
The prevalence of electrocardiographic early repolarization in an adult cohort with chronic kidney disease and its impact upon all-cause mortality and progression to dialysis
Hajhosseiny, R., Rajani, R., Khavandi, K., Sebag, F. A., Mashayekhi, S., Wright, M. J., & Goldsmith, D. J. A. (2013) · Frontiers in Physiology · doi:10.3389/fphys.2013.00127 · Cited by 5
“Finally, in a study of 1945 individuals aged between 35 and 74 years of age (Sinner et al., 2010), found a greater than 2-fold-increased risk of cardiac mortality in participants with ER compared to individuals without ER.”
Background
J Wave Syndromes: Brugada and Early Repolarization Syndromes
Antzelevitch, C., & Barajas-Martinez, H. (2020) · Contemporary Cardiology · doi:10.1007/978-3-030-41967-7_30 · Cited by 10
The Phenomenon of Early Repolarization
Tikkanen, J. T. (2014) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.114.001792 · Cited by 5
The clinical significance of early repolarization: A meta-analysis of mortality risk
Elenizi, K., Alharthi, R., Gamil, S., Aldeen, A. S., & Alqarawi, W. (2025) · Journal of Electrocardiology · doi:10.1016/j.jelectrocard.2025.153939 · Cited by 4
An extreme example of early repolarization
Altunbaş, G. (2018) · The Anatolian Journal of Cardiology · doi:10.14744/anatoljcardiol.2018.14265 · Cited by 4
“Two major population-based studies consistently showed that inferior localization of early repolarization pattern carries the highest risk of arrhythmic death (6, 7).”
Early Repolarization: Not Benign Any More- the J-Wave Syndromes
Bronis, K., Kappos, K. G., & Manolis, A. S. (2012) · Hospital chronicles/Hospital Chronicles · doi:10.2015/hc.v7i4.513 · Cited by 4
Prevalence and Prognostic Value of Early Repolarization in Low Risk Surgical Patients
Ota, C., Shiono, S.-N., Fujino, Y., Kamibayashi, T., & Hayashi, Y. (2015) · BioMed Research International · doi:10.1155/2015/309260 · Cited by 4
“[6] documented that the overall prevalence of early repolarization was 13.”
BackgroundResult
Evolution of Early Repolarization Patterns after 5 Years in a Military Population at Low Cardiovascular Risk and Practical Implications in Military Medical Expertise
Vinsonneau, U., Pangnarind‐Heinz, V., Paleiron, N., Heinz, L. M., Rohel, G., Piquemal, M., Castellant, P., Abaléa, J., Mansourati, J., & Paule, P. (2014) · Annals of Noninvasive Electrocardiology · doi:10.1111/anec.12231 · Cited by 4
J-Wave Syndromes
Viskin, S., & Rosso, R. (2017) · Elsevier eBooks · doi:10.1016/b978-0-323-44733-1.00096-1 · Cited by 4
Long-Term Follow-Up of Subjects Without Overt Heart Disease With an Early Repolarization/J Wave Electrocardiographic Pattern
Lanza, G. A., Melita, V., Vita, A. D., Bisignani, A., Mollo, R., & Crea, F. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.831381 · Cited by 4
“Some studies, indeed, found that the increased risk was related to the presence of a prominent J wave, but not of the typical ST-segment elevation (13, 14, 18) others showed a significant association with clinical events of notched, rather than slurred, J wave, and of inferior, rather than anterolateral, J wave locati…”
Result
Sudden Cardiac Death Risk Stratification of the Early Repolarization Syndrome: An Updated Review of the Literature
El-Azrak, M., Darar, C., Boutaybi, M., Ouafi, N. E., & Bazid, Z. (2023) · Current Cardiology Reports · doi:10.1007/s11886-023-01842-5 · Cited by 4
The Role of Holter Monitoring in the Diagnosis of Early Repolarisation Pattern
Ji, C., Chen, X., Cheng, Y., Liu, L., Tang, K., Zhu, W.-Q., Huang, Y., Chen, W., & Wu, S. (2017) · Heart Lung and Circulation · doi:10.1016/j.hlc.2017.10.005 · Cited by 4
Early repolarization pattern in an ethnically diverse population: Increased risk in Hispanics
Leiderman, E., Kargoli, F., Shulman, E. H., Aagaard, P., Hoch, E. G., Zaremski, L., Biase, L. D., Kim, S. G., GROSS, J. N., Ferrick, K. J., et al. (2019) · Pacing and Clinical Electrophysiology · doi:10.1111/pace.13827 · Cited by 4
Prevalence of Early Repolarization Patterns in Adults.
Barakoti, M. P., Karki, A., Chaulagain, M., & Karki, D. B. (2016) · PubMed · Cited by 4
ST-Segment Elevation: Defined by the Company It Keeps
O’Keefe, J. H., Bybee, K. A., Lavie, C. J., & Hammill, S. C. (2012) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2012.05.003 · Cited by 4
Early Repolarization: A Rare Primary Arrhythmic Syndrome and Common Modifier of Arrhythmic Risk
Roberts, J. D., & Gollob, M. H. (2013) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.12156 · Cited by 3
The Role of the Ratio of J‐Point Elevation Magnitude and R‐Wave Amplitude on the Same ECG Lead in the Risk Stratification of Subjects With Early Repolarization Pattern
Chen, X.-M., Ji, C.-C., Cheng, Y., Liu, L., Zhu, W.-Q., Huang, Y., Chen, W., & Wu, S. (2016) · Clinical Cardiology · doi:10.1002/clc.22587 · Cited by 3
Progression of early repolarization patterns at a four year follow‐up in a female flight crew population: Implications for aviation medicine
Rohel, G., Perrier, E., Delluc, A., Monin, J., Manen, O., Paule, P., Piquemal, M., Mansourati, J., & Vinsonneau, U. (2017) · Annals of Noninvasive Electrocardiology · doi:10.1111/anec.12451 · Cited by 3
Impact of Ethnicity on the Prevalence of Early Repolarization Pattern in Children: Comparison Between Caucasian and African Populations
Creta, A., Arigliani, M., Gioia, G. D., Lapenna, R., Quintarelli, F., Fittipaldi, M., Antinolfi, V., Bettini, R., Costanzo, D., Cruciani, A., et al. (2019) · Pediatric Cardiology · doi:10.1007/s00246-019-02185-1 · Cited by 3
Korai repolarizációs mintázatot mutató fiatal férfiak echokardiográfiás jellemzőinek összehasonlító vizsgálata
Szabó, I. A., Kocsis, L., László, S., Fehérvári, L., Fárr, A.-M., & Frigy, A. (2021) · Orvosi Hetilap · doi:10.1556/650.2021.32061 · Cited by 3
Prevalence of Brugada-type ECG pattern and early ventricular repolarization pattern in Tunisian athletes
Ouali, S., Salem, D. B., Hammas, Neffeti, Remedi, Mahdhaoui, Boughzala, Mankai, & Salem (2011) · Open Access Journal of Sports Medicine · doi:10.2147/oajsm.s19029 · Cited by 3
Brugada syndrome and early repolarization syndrome: Cellular basis and clinical features
Nam, G. (2013) · Journal of Arrhythmia · doi:10.1016/j.joa.2013.01.003 · Cited by 3
“In contrast, patients with ER according to the new definition (the presence of the terminal QRS notch or slur, irrespective of the ST segment changes) [19–22], have prognostic implications.”
BackgroundMethod
Intercellular conductance variability influences early repolarization potentials in a model of the myocardial tissue with stochastic architecture
Corlan, A. D., Amuzescu, B. P., Milicin, I., Iordachescu, V., Poenaru, E., Corlan, I., & AMBROGGI, L. D. (2011) · Cited by 3
Ethnic variation in prevalence of end QRS notching and slurring in apparently healthy populations
Clark, E., & Macfarlane, P. W. (2014) · Computing in cardiology · Cited by 3
J Point Elevation in Hypertrophic Cardiomyopathy
Maron, M. S. (2017) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2017.06.004 · Cited by 3
“Numerous subsequent studies in normal populations have suggested that the presence of a J wave confined to the inferior or lateral leads with horizontal or descending ST-segments identifies individuals at the highest risk for VF (7).”
Background
Early Repolarization: A Comparative Study of Demographic and Ethnic Differences
Elenizi, K., Alharthi, R., Gamil, S., Aldeen, A. S., & Alqarawi, W. (2025) · Pacing and Clinical Electrophysiology · doi:10.1111/pace.70042 · Cited by 2
The Significance of Early Repolarization and Incomplete Right Bundle Block in Athletes
Rafla, S. M. (2020) · International Journal of Sports and Exercise Medicine · doi:10.23937/2469-5718/1510168 · Cited by 2
“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.”
BackgroundInfluential
Autonomic Influences Related to Early Repolarization in Patients Without Structural Heart Disease
Chen, X., Fan, J., Cheng, Y., Ji, C., Yao, F., & Wu, S. (2020) · Journal of Cardiovascular Translational Research · doi:10.1007/s12265-020-10033-4 · Cited by 2
Is Early Repolarization Syndrome a Risk for Sudden Cardiac Death in Young Athletes?
Tremamunno, S., & Lanza, G. A. (2023) · Current Treatment Options in Cardiovascular Medicine · doi:10.1007/s11936-023-01007-1 · Cited by 2

Authors: Sinner, M. F., Reinhard, W., Müller, M., Beckmann, B.-M., Martens, E., Perz, S., Pfeufer, A., Winogradow, J., Stark, K., Meisinger, C., Wichmann, H.-E., Peters, A., Riegger, G. A. J., Steinbeck, G., Hengstenberg, C., & Kääb, S.
Affiliations: Ludwig-Maximilians-Universität München (DE)
University Hospital Regensburg (DE)
Helmholtz Munich (DE)
Corresponding author: Kääb, Stefan
ORCID: Sinner, Moritz F.
Reinhard, Wibke
Martens, Eimo
Stark, Klaus
Meisinger, Christa
Wichmann, H.-Erich
Peters, Annette
Steinbeck, Gerhard
Hengstenberg, Christian
Kääb, Stefan
Venue: PLoS Medicine
Publisher: Public Library of Science (PLoS)
Published: 2010-07-27
Volume: 7
Issue: 7
Pages: e1000314
ISSN: 1549-1277 (ISSN-L)
1549-1676
DOI: 10.1371/journal.pmed.1000314
PMC: PMC2910598
OpenAlex: W2133142369
Cited by: 282
References: 35
Citations by year: 2026: 7 · 2025: 6 · 2024: 4 · 2023: 7 · 2022: 12 · 2021: 6 · 2020: 11 · 2019: 18 · 2018: 14 · 2017: 25 · 2016: 32 · 2015: 26 · 2014: 19 · 2013: 39 · 2012: 24
FWCI: 20.87
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (unspecified)
Locations: PLoS Medicine (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Open access LMU (Ludwid Maxmilian's Universitat Munchen) (submittedVersion)
Figshare (submittedVersion, cc-by)
mediaTUM (Technical University of Munich) (submittedVersion)
Site cant be reached (submittedVersion, cc-by)
OPUS (Augsburg University) (submittedVersion, cc-by)
Funders: Deutsche Forschungsgemeinschaft
Fondation Leducq (01GS0838)
Bundesministerium für Bildung und Forschung (01GS0499, 01GS0838)
Münchner Zentrum für Gesundheitswissenschaften
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords: early repolarization, electrocardiogram, cardiac mortality, all-cause mortality, sudden cardiac death, age-stratified risk, sex differences, middle-aged adults, cardiovascular risk factors, Central European population, idiopathic ventricular fibrillation, sudden cardiac arrest, cardiovascular disease monitoring, cardiovascular disease prevention, cardiovascular disease treatment
MeSH terms: Adult, Aged, Cause of Death, Electrocardiography, Female, Germany, Heart Diseases, Humans, Male, Middle Aged, Population, Population Surveillance, Prospective Studies, Risk, Time Factors, Cohort Studies, Case-Control Studies

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Association of Early Repolarization Pattern on ECG with Risk of Cardiac and All-Cause Mortality: A Population-Based Prospective Cohort Study (MONICA/KORA)

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