Is Early Repolarization Syndrome a Risk for Sudden Cardiac Death in Young Athletes?

Purpose of review To review data available in medical literature on the prognostic implications of the detection of an “early repolarization” (ER) pattern at standard electrocardiogram (ECG) in athletes, with particular reference to a possible increased risk of sudden death. Recent findings In 2010, a case–control study of patients with vs. without idiopathic ventricular fibrillation in athletes found a higher prevalence of infero-lateral slurring J wave in cases than controls (28.6% vs. 7.6%; p = 0.006). Subsequently, a few studies assessed the prognostic value of the ER pattern (J point/ST-segment elevation with a typical ascending morphology and/or J wave with a notched morphology or with slurred QRS) in populations of athletes. Overall, a number of 3882 athletes were included in 5 studies, 1330 of whom (34.3%) had some evidence of ER pattern. No case of sudden death, as well as no increased risk of cardiovascular events, was reported in these studies. Summary Our revision of population studies involving athletes in medical literature failed to find any apparent increase of the arrhythmic risk associated with ER/J wave, which, therefore, should be continued to be considered as benign findings on standard ECG.