Key result
J-point elevation appears ~3 times more often in idiopathic ventricular fibrillation cases than matched controls.
Why the study?
J-point elevation has been considered an innocent ECG finding but is increasingly associated with idiopathic ventricular fibrillation, requiring clarification of its arrhythmic risk significance.
Case-Control (n=290)
Absolute Event Rate: 42% vs 13%
p-value: p=0.001
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“In population studies, the presence of a J wave increases the risk of idiopathic VF from 3.4 per 100,000 to 11 per 100,000, making the odds that an individual has a fatal disease 1:10,000, which is too small to influence management.”
Case-control study reveals elevated J-point prevalence in ventricular fibrillation survivors, indicating an association between early repolarization and sudden cardiac arrest.
OBJECTIVES: The purpose of this study was to determine whether J-point elevation is a marker of arrhythmic risk. BACKGROUND: J-point elevation has been considered an innocent finding among healthy young individuals (the "early repolarization" pattern). However, this electrocardiogram (ECG) finding is increasingly being associated with idiopathic ventricular fibrillation (VF). METHODS: In a case-control study, the ECG of 45 patients with idiopathic VF were compared with those of 124 age- and gender-matched control subjects and with those of 121 young athletes. We measured the height of J-point and ST-segment elevation and counted the presence of slurring in the terminal portion of the R-wave. RESULTS: J-point elevation was more common among patients with idiopathic VF than among matched control subjects (42% vs. 13%, p = 0.001). This was true for J-point elevation in the inferior leads (27% vs. 8%, p = 0.006) and for J-point elevation in leads I to aVL (13% vs. 1%, p = 0.009). J-point elevation in V(4) to V(6) occurred with equal frequency among patients and matched control subjects (6.7% vs. 7.3%, p = 0.86). Male subjects had J-point elevation more often than female subjects and young athletes had J-point elevation more often than healthy adults but less often than patients with idiopathic VF. The presence of ST-segment elevation or QRS slurring did not add diagnostic value to the presence of J-point elevation. CONCLUSIONS: J-point elevation is found more frequently among patients with idiopathic VF than among healthy control subjects. The frequency of J-point elevation among young athletes is intermediate (higher than among healthy adults but lower than among patients with idiopathic VF).
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Rosso et al. (2008) conducted a case-control in Idiopathic ventricular fibrillation (n=290). Idiopathic ventricular fibrillation vs. Matched control subjects was evaluated on J-point elevation (p=0.001). J-point elevation was significantly more frequent among patients with idiopathic ventricular fibrillation than among matched control subjects (42% vs. 13%, p=0.001).
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