Ventricular and Supraventricular Ectopy in Subjects With Early Repolarization

  • Teresa Trenkwalder
    Affiliations
    Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany

    German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
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  • Ryan King
    Affiliations
    Klinik und Poliklinik für Innere Medizin B, Universitätsmedizin Greifswald, Greifswald, Germany

    German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
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  • Bernhard M. Kaess
    Affiliations
    Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany

    Medizinische Klinik I, St. Josefs-Hospital, Wiesbaden, Germany
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  • Christian Hengstenberg
    Affiliations
    Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany

    German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
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  • Heribert Schunkert
    Affiliations
    Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany

    German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
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  • Till Ittermann
    Affiliations
    Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany

    German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
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  • Stephan B. Felix
    Affiliations
    Klinik und Poliklinik für Innere Medizin B, Universitätsmedizin Greifswald, Greifswald, Germany

    German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
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  • Mathias Busch
    Affiliations
    Klinik und Poliklinik für Innere Medizin B, Universitätsmedizin Greifswald, Greifswald, Germany

    German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
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  • Marcus Dörr
    Affiliations
    Klinik und Poliklinik für Innere Medizin B, Universitätsmedizin Greifswald, Greifswald, Germany

    German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
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  • Wibke Reinhard
    Correspondence
    Corresponding author: Tel: (+49) 89-1218-4025; fax: (+49) 89-1218-4016.
    Affiliations
    Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany

    German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
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      Early repolarization (ER) is a common electrocardiographic (ECG) finding that is associated with an increased risk of idiopathic ventricular fibrillation and sudden cardiac death. This study investigated whether the presence of ER is a predictor of ventricular and supraventricular ectopy as a marker for electrical instability. Standard 12-lead electrocardiograms of the first follow-up in the population-based Study of Health in Pomerania (SHIP-1) (n = 3,300, age 20 to 79 years) were analyzed to identify subjects with an ER pattern. Ventricular and supraventricular ectopy was assessed via portable tele-ECG cards recording 2 electrocardiograms daily over the course of 4 weeks. Data of 1,630 subjects (n = 83,833 ECG card recordings, average 51.4 per subject) were analyzed for ventricular and supraventricular ectopy using a standardized automated algorithm. Associations of ER and several forms of arrhythmias were assessed using a 2-sided Fisher's exact test or t test, where appropriate. Overall, prevalence of ER in the SHIP-1 population was 4.8%. Presence of ER was not associated with the occurrence of ventricular and supraventricular arrhythmias (p ≥0.05 for all analyses). Furthermore, subgroup analyzes for ER localization (inferior) and ST-segment morphology (horizontal/descending) did not show any association with arrhythmic events. In conclusion, presence of the ER pattern is not associated with an increased occurrence of ventricular or supraventricular arrhythmias as assessed by serial ECG card recordings in this large population-based sample.
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