TY - JOUR
T1 - Depolarization versus repolarization abnormality underlying inferolateral J-wave syndromes
T2 - New concepts in sudden cardiac death with apparently normal hearts
AU - Haïssaguerre, Michel
AU - Nademanee, Koonlawee
AU - Hocini, Mélèze
AU - Cheniti, Ghassen
AU - Duchateau, Josselin
AU - Frontera, Antonio
AU - Sacher, Frédéric
AU - Derval, Nicolas
AU - Denis, Arnaud
AU - Pambrun, Thomas
AU - Dubois, Rémi
AU - Jaïs, Pierre
AU - Benoist, David
AU - Walton, Richard D.
AU - Nogami, Akihiko
AU - Coronel, Ruben
AU - Potse, Mark
AU - Bernus, Olivier
PY - 2019/5/1
Y1 - 2019/5/1
N2 - 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.
AB - 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.
KW - Early repolarization
KW - J-wave syndrome
KW - Sudden death
KW - Ventricular fibrillation
UR - http://www.scopus.com/inward/record.url?scp=85059082453&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.hrthm.2018.10.040
DO - https://doi.org/10.1016/j.hrthm.2018.10.040
M3 - Article
C2 - 30391571
SN - 1547-5271
VL - 16
SP - 781
EP - 790
JO - Heart Rhythm
JF - Heart Rhythm
IS - 5
ER -