{"id":24328,"date":"2018-05-24T06:17:56","date_gmt":"2018-05-24T00:47:56","guid":{"rendered":"https:\/\/cardiophile.org\/?p=24328"},"modified":"2024-02-06T06:44:25","modified_gmt":"2024-02-06T01:14:25","slug":"ecg-quiz-discussion-3","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-discussion-3\/","title":{"rendered":"ECG quiz &#8211; Discussion"},"content":{"rendered":"<h2><span style=\"color: #008000;\">Findings and diagnosis?<\/span><\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-24314 size-large\" style=\"color: initial;\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2018\/05\/ECG-1-1024x503.jpg\" alt=\"Early repolarization syndrome\" width=\"640\" height=\"314\" \/><\/p>\n<p>Early repolarization syndrome<span style=\"color: #0000ff;\"><span style=\"color: #000000;\">Concave upwards ST segment elevation with a notch at the end of the QRS complex (J point) or a slurring of the terminal QRS seen in lateral leads is characteristic of early repolarization syndrome (ERPS). Till recently ERPS was considered as a benign condition, only thought of in the differential diagnosis of ST elevation myocardial infarction. But a paper by Haissaguerre\u00a0 M et al in\u00a0<em>NEJM <\/em>[1]\u00a0in 2008 brought ERPS into limelight as a potential arrhythmogenic condition. Actually the same group had highlighted on the new syndrome the previous year in the <em>Journal of Interventional Cardiac Electrophysiology\u00a0<\/em>[2].<\/span><\/span><\/p>\n<p>In an article by Frederic Sacher and Michel Haissaguerre in <em><a href=\"https:\/\/www.babymhospital.org\/BMH_MJ\/index.php\/BMHMJ\/article\/view\/55\/315\">BMH Medical Journal<\/a>\u00a0<\/em>[3], they highlighted on the need for specific definition for ERPS. They also mentioned that having an ERPS pattern is not a disease by itself. But it is crucial to give importance when there is a family history of sudden cardiac death and in patients with syncope having dramatic J point elevation and a descending\/horizontal ST segment. They mentioned that even though 5% of Caucasian population may have this ECG pattern, only 1\/2500 are at risk of ventricular fibrillation.<\/p>\n<p>Another article by the same group of authors has given a few ECG examples in which ventricular fibrillation occurred after an ectopic beat in those with early repolarization syndrome [4].<\/p>\n<p><span style=\"color: #0000ff;\"><strong>Reference<\/strong><\/span><\/p>\n<ol>\n<li>Haissaguerre M, Derval N, Sacher F, Jesel L, Deisenhofer I, de Roy L, Pasquie JL, Nogami A, Babuty D, Yli-Mayry S, De Chillou C, Scanu P, Mabo P, Matsuo S, Probst V, Le Scouarnec S, Defaye P, Schlaepfer J, Rostock T, Lacroix D, Lamaison D, Lavergne T, Aizawa Y, Englund A, Anselme F, O&#8217;Neill M, Hocini M, Lim KT, Knecht S, Veenhuyzen GD, Bordachar P, Chauvin M, Jais P, Coureau G, Chene G, Klein GJ, Clementy J. Sudden cardiac arrest associated with early repolarization. N Engl J Med. 2008; 358: 2016-2023.<\/li>\n<li>Haissaguerre M, Sacher F, Derval N, Jesel L, Deisenhofer I, de Roy L, Pasquie JL, Nogami A, Babuty D, Yli-Mayry S, Anselme F, Aizawa Y, Scanu P, Mabo P, Matsuo S, Probst V, Lavergne T, Defaye P, Maury P, Lamaison D, Hocini M, Lim KT, Veenhuyzen G, Bordachar P, Jais P, Klein G, Clementy J. Early Repolarization in the Inferolateral Leads: A New Syndrome Associated with Sudden Cardiac Death. J Interv Card Electrophysiol. 2007; 18: 281.<\/li>\n<li>Sacher F, Haissaguerre M.\u00a0Early Repolarization Syndrome.\u00a0BMH Medical Journal 2015;2(2):28-30.<\/li>\n<li>Bourier F, Denis A, Cheniti G, Lam A, Vlachos K, Takigawa M, Kitamura T, Frontera A, Duchateau J, Pambrun T, Klotz N, Derval N, Sacher F, Jais P, Haissaguerre M, Hocini M. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6278243\/\">Early Repolarization Syndrome: Diagnostic and Therapeutic Approach<\/a>. Front Cardiovasc Med. 2018 Nov 27;5:169. doi: 10.3389\/fcvm.2018.00169. PMID: 30542653; PMCID: PMC6278243.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Findings and diagnosis? Early repolarization syndromeConcave upwards ST segment elevation with a notch at the end of the QRS complex (J point) or a slurring of the terminal QRS seen in lateral leads is characteristic of early repolarization syndrome (ERPS). Till recently ERPS was considered as a benign condition, only thought of in the differential [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":24314,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[6,7],"tags":[],"class_list":["post-24328","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ecg-electrophysiology","category-ecg-library"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ECG quiz discussion: Early repolarization syndrome<\/title>\n<meta name=\"description\" content=\"Concave upwards ST segment elevation with a notch at the end of the QRS complex (J point) or a slurring of the terminal QRS seen in lateral leads is characteristic of early repolarization syndrome.\u00a0\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-discussion-3\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ECG quiz discussion: Early repolarization syndrome\" \/>\n<meta property=\"og:description\" content=\"Concave upwards ST segment elevation with a notch at the end of the QRS complex (J point) or a slurring of the terminal QRS seen in lateral leads is characteristic of early repolarization syndrome.\u00a0\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-discussion-3\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2018-05-24T00:47:56+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-02-06T01:14:25+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-discussion-3\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-discussion-3\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"ECG quiz &#8211; 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