Early repolarization in the athlete: just a benign finding?
Keywords:
Early repolarization, athleteAbstract
Electrocardiographically defined as J-point elevation, ST-segment elevation, J waves or terminal QRS slurring in the lower (IBD, DIII and aVF) and/or lateral (DI, aVL, V4-V6) leads1, Early Repolarization is traditionally considered a benign electrocardiographic variant, present in about 5% of the world population2.
At one end of the spectrum of Early Repolarization, this is considered a benign finding, predominantly found in young people and athletes3, with an estimated prevalence of 20 to 90% of this population4, strongly associated with intense physical exercise. However, a limited number of studies have associated this finding with the occurrence of idiopathic ventricular fibrillation or sudden cardiac death1,2,5, and several genetic variants have been pointed out as the underlying electrophysiological pathology2. This other end of the spectrum of Early Repolarization refers to a "syndrome" that presents with sudden cardiac death, often in the context of a structurally normal heart2.
This "syndrome", called Early Repolarization Syndrome, is diagnosed when an Early Repolarization pattern is observed (elevation of the J point > 1mm in two or more contiguous lateral and/or inferior electrocardiographic leads) in an individual resuscitated after an event of polymorphic ventricular tachycardia or ventricular fibrillation without any known heart disease6.
