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In heart health, what is early repolarization and what does it say about a person's...

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tiburtius | High School Teacher | (Level 3) Associate Educator

Posted March 18, 2013 at 12:58 PM via web

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In heart health, what is early repolarization and what does it say about a person's health?

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belarafon | High School Teacher | (Level 2) Educator Emeritus

Posted March 18, 2013 at 8:35 PM (Answer #1)

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Benign early repolarization, often shortened to simply early repolarization, is a shape on the output of an electrocardiogram reading, also called J-waves or J-point elevation (circ.ahajournals.org). It is associated with chest pains, occurring in about 1% of those cases. For many years, the condition of ERP was thought to be benign, thus the name; recent studies have shown that ERP might be more indicative of potential heart troubles, including idiopathic ventricular fibrillation, and so modern usage usually omits the word "benign" as the studies simply aren't certain enough. For example, the article "Definition of Early Repolarization: A Tug of War" by Derval et al that is cited below states:

In the seminal article by Haïssaguerre et al, cases of ERP associated with cardiac arrest had at least 0.1-mV J point elevation manifested as QRS slurring or notching in the 2 contiguous inferior or lateral leads. ERP has also emerged as a marker of increased long-term mortality (cardiac and arrhythmic) in the general population. Thus, ERP is probably not as benign as traditionally believed.

Because of its low incidence rate in heart-related deaths, and its historical association with athletes (uptodate.com), etc., ERP was not considered a marker for those conditions. However, this is precisely because of the condition's already-low rates; since ERP only appears in 1% of patients complaining about chest pains, it is easily dismissed and then ignored if the patient eventually dies of a heart-related issue. These recent studies show that ERP is also widely misdiagnosed or ignored as "normal" for these reasons. While it is not currently considered a marker for heart-related issues, ERP is undergoing a reinvestigation in its associations and any tendencies towards indication of possible health problems later. These studies will help the medical community come to a consensus as to the nature of ERP's possible meanings, and whether it should be considered benign (unimportant to overall heart health) or malignant (possibly directly related to heart health problems).

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