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The early repolarization normal variant electrocardiogram: correlates and consequences - 28/08/11

Doi : 10.1016/S0002-9343(03)00355-3 
Arthur L Klatsky, MD a, , Rudolph Oehm, MD a, Robert A Cooper, MD a, Natalia Udaltsova, PhD a, Mary Anne Armstrong, MA a
a Division of Cardiology, Department of Medicine, and the Division of Research, Kaiser Permanente Medical Care Program, Oakland, California, USA 

*Requests for reprints should be addressed to Arthur L. Klatsky, MD, Kaiser Permanente Medical Center, 280 West MacArthur Boulevard, Oakland, California 94611, USA

Abstract

Purpose

We compared the characteristics and outcomes of patients with “early repolarization” electrocardiograms (ECGs) with those who had normal ECGs.

Methods

In 1983 to 1985, we collected photocopies of 2234 selected ECGs from 73,088 patients undergoing health examinations. Excluding 153 ECGs with missing data or that were judged to be abnormal, the remaining ECGs were reinterpreted in 2000 by cardiologists as showing early repolarization (n = 670), or being borderline (n = 330) or normal (n = 1081). Characteristics and outcomes of persons with early repolarization ECGs were compared with those who had normal ECGs using analysis of variance, logistic regression, or proportional hazards models. Information on exercise was available in 325 patients.

Results

Patients with early repolarization were more likely to be male (81% [n = 583] vs. 33% [n = 360]), <40 years old (60% [n = 441] vs. 37% [n = 403]), black (48% [n = 384] vs. 26% [n = 280]), and more athletically active (mean [± SD], 10.4 ± 1.3 hours per week of activity vs. 6.4 ± 1.2 hours per week of activity) than those with normal ECGs. Patients with early repolarization were not more likely to be hospitalized (hazard ratio [HR] = 1.0; 95% confidence interval [CI]: 0.9 to 1.2) or to die (HR = 0.8; 95% CI: 0.6 to 1.2) during follow-up than those with normal ECGs. Outpatient diagnoses were not more common in those with early repolarization; arrhythmias were actually less common (P <0.01).

Conclusion

Although especially prevalent in young, athletic, black men, early repolarization is not rare in other patients. The long-term prognosis of early repolarization is benign.

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Esquema


 This work was supported by a grant from the Kaiser Foundation Research Institute, Oakland, California. Data collection in 1983 to 1985 was supported by a grant from the Alcoholic Beverage Medical Research Foundation, Baltimore, Maryland.


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Vol 115 - N° 3

P. 171-177 - août 2003 Regresar al número
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