The following is the summary of “Prognostic Assessment of Early Repolarization/J Wave Electrocardiographic Pattern in Patients With Stable Ischemic Heart Disease,” published in the January 2023 issue of Cardiovascular Disease by Lanza, et al.

Recent research has linked the presence of an early repolarization (ER)/J wave on the electrocardiogram (ECG) to a higher risk of sudden mortality and ventricular arrhythmias in individuals with acute myocardial infarction. Whether or not ER/J wave is associated with long-term prognosis in individuals with stable ischemic heart disease(IHD) was prospectively evaluated in this study. Patients with established ischemic heart disease (IHD) referred for a regular electrocardiogram (ECG) were consecutively included. 

Objective criteria for the diagnosis of ER (characterized by a concave ST-segment elevation) and J wave were established. There were a total of 617 patients, 455 of them were men, and their average age was 68.1 ± 11 years; they all had verified IHD. About 13 (2.1%) patients had ER, and 133 (21.6%) showed J wave, for a total of 138 patients (22.4%) with ER/J wave. A total of 160 deaths (24.9%) occurred during the 8.1 ± 2.9-year follow-up period, with 60 deaths (9.7%) due to cardiovascular causes. Patients with the ER/J wave had a reduced overall mortality rate than those without it (18.8% vs. 28.0%; HR 0.61, 95% CI 0.40 to 0.93, P=0.02). After considering potentially influential clinical factors, however, the difference was no longer statistically significant (HR 0.78, 95% CI 0.51 to 1.19, P=0.25). 

Those patients with an ER/J wave were found to have a lower risk of cardiovascular death (7.2% vs. 10.4%; adjusted HR 0.78, 95% CI 0.40 to 1.55, P=0.48). Results were consistent when analyzing ER and J waves independently and considering the inferior, lateral, or precordial position of the ER/J waves on an electrocardiogram (ECG) (notched or slurred). In clinically stable patients with a documented IHD history, the ER/J wave pattern on the electrocardiogram is unrelated to an increased risk of long-term mortality.

Source: sciencedirect.com/science/article/abs/pii/S0002914922010657