Electrocardiographic Risk Stratification of Patients with Early Repolarization Syndrome
Translated title
Elektrokardiograifsk Risiko Stratificering af Patienter med Tidlig repolarisering syndrom
Author
Jensen, Asger Ågård
Term
4. term
Publication year
2011
Submitted on
2011-06-08
Pages
82
Abstract
I næsten 60 år blev tidlig repolarisation (ER) på elektrokardiogrammet (EKG) betragtet som et harmløst fund. Nyere studier tyder dog på, at visse ER‑mønstre kan være forbundet med en øget risiko for pludseligt hjertestop – selv hos atleter. Det har ført til mistanke om, at der findes et spektrum fra asymptomatisk til mere ondartet ER. Formålet med dette projekt var at finde EKG‑parametre, som kan hjælpe læger med at identificere personer med ER, der kan have forhøjet risiko for pludselig hjertedød. Vi analyserede EKG‑optagelser fra 40 raske personer, 66 mandlige atleter og 33 mandlige overlevere af hjertestop under hypotermi. For at forbedre signal‑støj‑forholdet blev middelkomplekser (beat‑averaging) anvendt. Vi undersøgte 15 parametre, herunder mål for J‑bølge, slur og notch, for at beskrive forskelle i timing, varighed og form mellem grupperne. Parametrene blev beregnet ud fra ER‑fiducielle punkter, som blev manuelt annoteret, og hver deltager blev manuelt klassificeret med eller uden ER. ER blev observeret oftere hos atleter end i en aldersmatchet ikke‑atletisk gruppe, og hyppigst hos overlevere af hjertestop under hypotermi (76,5%). Forekomsten var signifikant forskellig mellem grupperne. Hos personer med ER var varighed, timing og form af ER‑mønstre hos konkurrenceatleter ikke signifikant forskellige fra ikke‑atleter. Der sås dog en tendens til, at atleters ER‑mønstre lignede dem, der blev observeret hos overlevere af hjertestop under hypotermi. Disse resultater peger på, at nogle ER‑mønstre hos atleter kan dele kendetegn med højere risiko, men yderligere forskning er nødvendig for at bekræfte fundene og udvikle bedre værktøjer til risikovurdering.
For nearly 60 years, early repolarization (ER) on the electrocardiogram (ECG) was considered a harmless finding. More recent studies, however, suggest that certain ER patterns may be linked to a higher risk of sudden cardiac arrest—even in athletes—raising the possibility of a spectrum from asymptomatic to more malignant ER. This project aimed to identify ECG parameters that could help clinicians recognize individuals with ER who may be at increased risk of sudden cardiac death. We manually analyzed ECGs from 40 healthy participants, 66 male athletes, and 33 male survivors of cardiac arrest during hypothermia. To improve the signal‑to‑noise ratio, we constructed averaged beats. We examined 15 parameters, including measures of the J‑wave, slur, and notch, to quantify differences in timing, duration, and morphology across groups. Parameters were computed from manually annotated ER fiducial points, and each participant was manually classified as having ER or not. ER was observed more frequently in athletes than in an age‑matched non‑athlete group, and most frequently in survivors of cardiac arrest during hypothermia (76.5%). The prevalence differed significantly between groups. Among individuals with ER, the duration, timing, and shape of ER patterns in competitive athletes did not differ significantly from those in non‑athletes. However, there was a tendency for athletes’ ER patterns to resemble those seen in hypothermia cardiac arrest survivors. These findings suggest that some athletic ER patterns may share features associated with higher risk, but further research is needed to confirm these observations and to improve risk stratification.
[This abstract was generated with the help of AI]
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