Key result
Early repolarization links to increased risk of sudden cardiac death and idiopathic ventricular fibrillation.
This review highlights that while early repolarization is generally benign, specific ECG features like inferior J point elevation and horizontal/descending ST segments are markers of increased sudden cardiac death risk.
Specific early repolarization patterns may flag higher SCD risk and warrant caution; leaves open prospective validation before clinical adoption.
For more than 70 years, early repolarization has been considered to be a common normal variant. In the general population, the prevalence ranges between 5 and 13%, and in athletes, a rising trend is observed from 20 to 90%. Nevertheless, from the latter half of the 1990s, a growing number of case reports, series, observational and prospective studies reported that the presence of various electrocardiographic patterns attributed to early repolarization may constitute a potential marker for the increased risk of sudden death in otherwise normal individuals, casting a dark shadow on this ECG peculiarity. This review provides a historical summary of the evolution of the concept of early repolarization from its original description to the latest works and a guide to help physicians in evaluating individuals with this common electrocardiographic pattern.
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Biasco et al. (2015) conducted a review in Early repolarization. Early repolarization pattern was evaluated. Early repolarization, traditionally considered a benign ECG variant, is increasingly recognized as a potential marker for increased risk of sudden cardiac death and idiopathic ventricular fibrillation.
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