Roten, LaurentLaurentRoten0000-0002-0827-1329Derval, NicolasNicolasDervalMaury, PhilippePhilippeMauryMahida, SaagarSaagarMahidaPascale, PatrizioPatrizioPascaleLeenhardt, AntoineAntoineLeenhardtJesel, LaurenceLaurenceJeselDeisenhofer, IsabelIsabelDeisenhoferKautzner, JosefJosefKautznerProbst, VincentVincentProbstRollin, AnneAnneRollinRuidavets, Jean-BernardJean-BernardRuidavetsFerrières, JeanJeanFerrièresSacher, FrédéricFrédéricSacherHeg, Dierik HansDierik HansHeg0000-0002-8766-7945Scherr, DanielDanielScherrKomatsu, YukiYukiKomatsuDaly, MatthewMatthewDalyDenis, ArnaudArnaudDenisShah, AshokAshokShahHocini, MélèzeMélèzeHociniJaïs, PierrePierreJaïsHaïssaguerre, MichelMichelHaïssaguerre2024-10-242024-10-242016https://boris-portal.unibe.ch/handle/20.500.12422/138127BACKGROUND Inferolateral early repolarization (ER) is highly prevalent and is associated with idiopathic ventricular fibrillation (VF). OBJECTIVE The purpose of this study was to evaluate the potential role of T-wave parameters to differentiate between malignant and benign ER. METHODS We compared the ECGs of patients with ER and VF (n = 92) with control subjects with asymptomatic ER (n = 247). We assessed J-wave amplitude, QTc interval, T-wave/R-wave (T/R) ratio in leads II and V5, and presence of low-amplitude T waves (T-wave amplitude <0.1 mV and <10% of R-wave amplitude in lead I, II, or V4-V6). RESULTS Compared to controls, the VF group had longer QTc intervals (388 ms vs 377 ms, P = .001), higher J-wave amplitudes (0.23 mV vs 0.17 mV, P <.001), higher prevalence of low-amplitude T waves (29% vs 3%, P <.001), and lower T/R ratio (0.18 vs 0.30, P <.001). Logistic regression analysis demonstrated that QTc interval (odds ratio [OR] per 10 ms: 1.15, 95% confidence interval [CI} 1.02-1.30), maximal J-wave amplitude (OR per 0.1 mV: 1.68, 95% CI 1.23-2.31), lower T/R ratio (OR per 0.1 unit: 0.62, 95% CI 0.47-0.81), presence of low-amplitude T waves (OR 3.53, 95% CI 1.26-9.88). and presence of J waves in the inferior leads (OR 2.58, 95% CI 1.18-5.65) were associated with malignant ER. CONCLUSION Patients with malignant ER have a higher prevalence of low-amplitude T waves, lower T/R ratio (lead II or V5), and longer QTc interval. The combination of these parameters with J-wave amplitude and distribution of J waves may allow for improved identification of malignant ER.enEarly repolarizationElectrocardiogramJ waveQT intervalVentricular fibrillation600 - Technology::610 - Medicine & health300 - Social sciences, sociology & anthropology::360 - Social problems & social services500 - Science::570 - Life sciences; biologyarticle10.7892/boris.759662659284910.1016/j.hrthm.2015.11.020