The Year of 2011 in Electrocardiology

EARLY REPOLARIZATION (ER) PATTERN IN THE ECGUndoubtedly, last year the subject of ER raised the most vivid discussion among electrocardiographists and electrophysiologists. Based on a follow-up of about 10 years of over 15,000 middleaged subjects, Olson et al. 1 demonstrated that the characteristic ST-elevation at the J-point was associated with an increased sudden cardiac death (SCD) in whites and in females, but not in blacks or males.Japanese investigators 2 reviewed the ECG records of nearly 6000 atomic bomb survivors who were examined at least once during biannual health examinations in Nagasaki between 1958 and 2004; ER pattern had an elevated risk of unexpected death and a decreased risk of cardiac and all-cause death, although the hazard ratio for unexpected death in ER pattern was lower than that in patients with Brugada (Br)-type ECG.The characteristics of the ECG manifestations of ER in a general population was scrutinized by Tikkanen et al.; 3 subjects with ER ≥ 0.1 mV and horizontal/descending ST-variant had an increased hazard ratio of arrhythmic death; an even higher hazard ratio of arrhythmic death was observed with higher amplitude ER in inferior leads and horizontal/descending ST-segment variant.In subjects with ascending ST, the relative risk for arrhythmic deaths was not increased.The heritability basis of ER pattern in the general population was stressed by Noseworthy et al.,