[HTML][HTML] Depolarization versus repolarization abnormality underlying inferolateral J-wave syndromes: new concepts in sudden cardiac death with apparently normal …

M Haïssaguerre, K Nademanee, M Hocini, G Cheniti… - Heart Rhythm, 2019 - Elsevier
M Haïssaguerre, K Nademanee, M Hocini, G Cheniti, J Duchateau, A Frontera, F Sacher…
Heart Rhythm, 2019Elsevier
Early repolarization indicates a distinct electrocardiographic phenotype affecting the junction
between the QRS complex and the ST segment in inferolateral leads (inferolateral J-wave
syndromes). It has been considered a benign electrocardiographic variant for decades, but
recent clinical studies have demonstrated its arrhythmogenicity in a small subset, supported
by experimental studies showing transmural dispersion of repolarization. Here we review
the current knowledge and the issues of risk stratification that limit clinical management. In …
Early repolarization indicates a distinct electrocardiographic phenotype affecting the junction between the QRS complex and the ST segment in inferolateral leads (inferolateral J-wave syndromes). It has been considered a benign electrocardiographic variant for decades, but recent clinical studies have demonstrated its arrhythmogenicity in a small subset, supported by experimental studies showing transmural dispersion of repolarization. Here we review the current knowledge and the issues of risk stratification that limit clinical management. In addition, we report on new mapping data of patients refractory to pharmacologic treatment using high-density electrogram mapping at the time of inscription of J wave. These data demonstrate that distinct substrates, delayed depolarization, and abnormal early repolarization underlie inferolateral J-wave syndromes, with significant implications. Finally, based on these data, we propose a new simplified mechanistic classification of sudden cardiac deaths without apparent structural heart disease.
Elsevier