Key result
Early repolarization links to idiopathic ventricular fibrillation despite controversial risk stratification for sudden cardiac death.
Why the study?
The benign paradigm of early repolarization pattern was challenged by evidence linking it to idiopathic ventricular fibrillation, prompting a review of risk stratification.
Risk stratification for early repolarization pattern remains controversial, highlighting the need for standardized definitions and future genetic/molecular research.
Caution advised when evaluating early repolarization in VF survivors; leaves open standardized risk stratification and prospective validation studies.
Introduction: Early repolarization pattern (ERP) has traditionally been related as a benign variant of electrocardiography (ECG). However, since 2008, when two studies were published for Haïssaguerre et al. and Rosso et al., with evidence of a higher prevalence of ERP in people with primary or idiopathic ventricular fibrillation (VF), this paradigm has been challenged. Objective: To conduct a thorough review of early repolarization and current state of the art regarding risk stratification in these patients. Methods: Literature review on the subject evaluating the works published in high impact journals. Conclusion: The correlation of risk factors and the real value of the various methods currently available as possible risk stratifiers is still controversial. Advances in genetics and molecular biology may in the future help in understanding the pathophysiology and better risk stratification in this population. In this context, the standardization of the definition and classification of early repolarization is imperative, as it will serve as a substrate for future studies and researches in the area.
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Chiarini et al. (2020) conducted a review in Early repolarization syndrome (Haïssaguerre syndrome). Early repolarization, traditionally considered benign, is associated with idiopathic ventricular fibrillation, although risk stratification methods for sudden cardiac death remain controversial.
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