Prevalence of J-Point Elevation in Sudden Arrhythmic Death Syndrome Families

• Published in: Journal of the American College of Cardiology 2011-07, Vol.58 (3), p.286-290
• Main Authors: Nunn, Laurence M., MD, Bhar-Amato, Justine, MD, Lowe, Martin D., MD, PhD, Macfarlane, Peter W., MD, DSc, Rogers, Pauline, MSc, McKenna, William J., MD, Elliott, Perry M., MD, Lambiase, Pier D., MD, PhD
• Format: Article
• Language: English
• Subjects: Adult; Age; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Arrhythmias, Cardiac - diagnosis; Arrhythmias, Cardiac - genetics; Biological and medical sciences; Cardiac arrhythmia; Cardiology; Cardiology. Vascular system; Cardiovascular; Confidence intervals; Death, Sudden, Cardiac - etiology; Drug therapy; early repolarization; Electrocardiography; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Female; Females; Heart attacks; Humans; Intensive care medicine; Internal Medicine; J-point elevation; Male; Medical sciences; Mortality; Population; sudden arrhythmic death; Ventricular Fibrillation - diagnosis; Ventricular Fibrillation - genetics
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2011.03.028

Objectives The purpose of this study was to assess the prevalence of J-point elevation among the relatives of sudden arrhythmic death syndrome (SADS) probands. Background J-point elevation is now known to be associated with idiopathic ventricular fibrillation. We hypothesized that this early repolarization phenomenon is an inherited trait responsible for a proportion of otherwise unexplained SADS cases. Methods Families of SADS probands were evaluated in an inherited arrhythmia clinic. Twelve-lead electrocardiograms were analyzed for J-point elevation defined as >0.1 mV from baseline present in 2 or more of the inferior (II, III, and aVF) or lateral (1, aVL, V4 to V6 ) leads. Electrocardiographic data were compared with those of 359 controls of a similar age, sex, and ethnic distribution. Results A total of 363 first-degree relatives from 144 families were evaluated. J-point elevation in the inferolateral leads was present in 23% of relatives and 11% of control subjects (odds ratio: 2.54, 95% confidence interval: 1.66 to 3.90; p < 0.001). Conclusions J-point elevation is more prevalent in the relatives of SADS probands than in controls. This indicates that early repolarization is an important potentially inheritable pro-arrhythmic trait or marker of pro-arrhythmia in SADS.