Key result
The presence of an early repolarization or J wave pattern on ECG was not significantly associated with total mortality (HR 0.94) or cardiovascular mortality during a 10-year follow-up in subjects without overt heart disease.
Why the study?
Controversial data existed regarding the prognostic implications of early repolarization and J wave in healthy subjects, with no longitudinal prospective study specifically designed to evaluate their long-term prognostic value.
Does the presence of an early repolarization/J wave pattern on ECG increase the risk of total or cardiovascular mortality in subjects without overt heart disease?
Cohort (n=3,937)
No
Does the presence of an early repolarization/J wave pattern on ECG increase the risk of total or cardiovascular mortality in subjects without overt heart disease?
In subjects without overt cardiovascular disease, the presence of an early repolarization or J wave pattern on ECG is not associated with increased long-term total or cardiovascular mortality.
ER/J wave pattern requires no specific action in asymptomatic subjects without heart disease; leaves open questions on arrhythmic risk in other groups.
Aims The “early repolarization” (ER) pattern and J wave are frequent findings on standard ECG. Controversial data have recently been reported about their prognostic implications in healthy subjects, but no longitudinal prospective study specifically designed to investigate their long-term prognostic value has hitherto been published. Methods and Results We prospectively enrolled 4,176 consecutive subjects with no evidence of cardiovascular disease who were referred for standard ECG recording for routine check-ups or pre-operative assessments for non-cardiovascular surgery. ECGs were prospectively assessed for the presence of ER/J wave. A 10-year follow-up was available for 3,937 patients (94.3%), 660 of whom (16.8%) showed ER/J wave whereas 3,277 did not. A total of 644 deaths occurred (16.3%), 116 (2.95%) of which were attributed to cardiovascular causes. Both total and cardiovascular mortality adjusted for clinical and laboratory variables did not differ significantly between patients with vs. without ER/J wave (HR 0.94; 95% CI 0.75–1.19; p = 0.63 and HR 0.61; 95% CI 0.31–1.21; p = 0.16, respectively). No significant association with total and cardiovascular mortality was also found in pre-specified analyses for ER and J wave alone, ER/J wave detected in specific ECG regions (i.e., inferior, lateral, precordial), and type of J wave (notched or slurred). Conclusion In this specifically designed prospective study of individuals without any evidence of cardiovascular disease, we found no significant association of ER/J wave with the risk of the total as well as cardiovascular mortality during long-term follow-up.
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Lanza et al. (2022) conducted a cohort in No overt heart disease (n=3,937). Early repolarization/J wave ECG pattern vs. No early repolarization/J wave ECG pattern was evaluated on Total mortality (HR 0.94, 95% CI 0.75-1.19, p=0.63). The presence of an early repolarization or J wave pattern on ECG was not significantly associated with total mortality (HR 0.94) or cardiovascular mortality during a 10-year follow-up in subjects without overt heart disease.
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