Role of electrophysiological studies in predicting risk of ventricular arrhythmia in early repolarization syndrome.

Mahida, Saagar; Derval, Nicolas; Sacher, Frederic; Leenhardt, Antoine; Deisenhofer, Isabel; Babuty, Dominique; Schläpfer, Jürg; de Roy, Luc; Frank, Robert; Yli-Mayry, Sinikka; Mabo, Philippe; Rostock, Thomas; Nogami, Akihiko; Pasquié, Jean-Luc; de Chillou, Christian; Kautzner, Josef; Jesel, Laurence; Maury, Philippe; Berte, Benjamin; Yamashita, Seigo; ... (2015). Role of electrophysiological studies in predicting risk of ventricular arrhythmia in early repolarization syndrome. Journal of the American College of Cardiology, 65(2), pp. 151-159. Elsevier 10.1016/j.jacc.2014.10.043

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The early repolarization (ER) pattern is associated with an increased risk of arrhythmogenic sudden death. However, strategies for risk stratification of patients with the ER pattern are not fully defined.


This study sought to determine the role of electrophysiology studies (EPS) in risk stratification of patients with ER syndrome.


In a multicenter study, 81 patients with ER syndrome (age 36 ± 13 years, 60 males) and aborted sudden death due to ventricular fibrillation (VF) were included. EPS were performed following the index VF episode using a standard protocol. Inducibility was defined by the provocation of sustained VF. Patients were followed up by serial implantable cardioverter-defibrillator interrogations.


Despite a recent history of aborted sudden death, VF was inducible in only 18 of 81 (22%) patients. During follow-up of 7.0 ± 4.9 years, 6 of 18 (33%) patients with inducible VF during EPS experienced VF recurrences, whereas 21 of 63 (33%) patients who were noninducible experienced recurrent VF (p = 0.93). VF storm occurred in 3 patients from the inducible VF group and in 4 patients in the noninducible group. VF inducibility was not associated with maximum J-wave amplitude (VF inducible vs. VF noninducible; 0.23 ± 0.11 mV vs. 0.21 ± 0.11 mV; p = 0.42) or J-wave distribution (inferior, odds ratio [OR]: 0.96 [95% confidence interval (CI): 0.33 to 2.81]; p = 0.95; lateral, OR: 1.57 [95% CI: 0.35 to 7.04]; p = 0.56; inferior and lateral, OR: 0.83 [95% CI: 0.27 to 2.55]; p = 0.74), which have previously been demonstrated to predict outcome in patients with an ER pattern.


Our findings indicate that current programmed stimulation protocols do not enhance risk stratification in ER syndrome.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Roten, Laurent


600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology








Laurent Roten

Date Deposited:

10 Feb 2015 08:21

Last Modified:

29 Oct 2015 09:12

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

early repolarization, sudden cardiac death, ventricular fibrillation




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