Augmentation of J Waves and Electrical Storms in Patients with Early Repolarization

Abstract

Early repolarization, consisting of an elevation of the QRS–ST junction (J point), QRS notching or slurring (J wave), and a tall, symmetric T wave, is generally considered to be benign.¹ On the basis of preclinical experimental evidence, it has been suggested that some forms of early repolarization seen in the clinic may not be benign, especially when associated with the occasional appearance of J waves or ST-segment elevation.² Sporadic case reports and basic electrophysiological research have suggested a critical role of the J wave in the pathogenesis of idiopathic ventricular fibrillation.^3,4 Clinical evidence in support of an association between early repolarization and idiopathic ventricular fibrillation was previously reported in preliminary form by Haïssaguerre et al. and is fully disclosed by these researchers in this issue of the Journal.⁵ However, direct evidence of a relation between early repolarization and the appearance of accentuated J waves in idiopathic ventricular fibrillation has been scarce.