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Early repolarization in children with unexplained syncope

I. Fernlund, Eva LU and Liuba, Petru LU (2011) In Journal of Electrocardiology 44(2). p.10-10
Abstract
Introduction: It has traditionally been believed that early repolarization (ER) is benign. Significant association between ER and sudden cardiac arrest due to idiopathic ventricular fibrillation was recently found in a large cohort of adult survivors of sudden cardiac arrest. In some prior studies, unexplained syncope has been linked to risk of sudden death, but the mechanisms remain speculative.We assessed herein the prevalence of ER in children referred to our center for unexplained syncope. Methods: We evaluated retrospectively electrocardiograms from such children (n = 29; mean age, 12.1 years; range, 7-18 years) for presence of ER, which was defined as an elevation of the QRS-ST junction (J-point) in at least 2 leads of at least 1 mm... (More)
Introduction: It has traditionally been believed that early repolarization (ER) is benign. Significant association between ER and sudden cardiac arrest due to idiopathic ventricular fibrillation was recently found in a large cohort of adult survivors of sudden cardiac arrest. In some prior studies, unexplained syncope has been linked to risk of sudden death, but the mechanisms remain speculative.We assessed herein the prevalence of ER in children referred to our center for unexplained syncope. Methods: We evaluated retrospectively electrocardiograms from such children (n = 29; mean age, 12.1 years; range, 7-18 years) for presence of ER, which was defined as an elevation of the QRS-ST junction (J-point) in at least 2 leads of at least 1 mm (0.1 mV) above the baseline level. The anterior precordial leads (V1-V3) were excluded from the analysis to avoid inclusion of patients with right ventricular dysplasia or Brugada syndrome. Agematched children (n = 33; mean age, 12.3 years; range, 7-16 years) with noncardiac chest pain were included as controls. Results: Early repolarization was detected in 45% (13/29) of children with unexplained syncope vs 24% (8/33) in the chest pain group. Among children with syncope, ER was far more frequent in males than in females (8/12 vs 5/ 17, respectively). Echocardiography showed normal functional and structural findings in all children. Conclusion: In this relatively small-scale retrospective study of children with unexplained syncope with otherwise normal cardiac findings, we found particularly among those of male gender a greater prevalence of ER than in controls (noncardiac chest pain).With view to earlier findings of Haisaguerre et al (NEJM 2008), this intriguing association warrants further prospective studies addressing its precise clinical implication and underlying mechanisms. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
keywords
child, faintness, repolarization, acute leukemia, male, prevalence, noncardiac chest pain, heart arrest, adult, survivor, risk, sudden death, electrocardiogram, patient, Brugada syndrome, thorax pain, female, echocardiography, retrospective study, gender, prospective study, heart ventricle fibrillation, heart right ventricle dysplasia
in
Journal of Electrocardiology
volume
44
issue
2
pages
10 - 10
publisher
Elsevier
ISSN
1532-8430
DOI
10.1016/j.jelectrocard.2010.12.031
language
English
LU publication?
yes
id
a712a3fd-86bb-4b54-a3e1-9df811e5e478
date added to LUP
2017-07-21 10:28:26
date last changed
2017-08-07 16:15:17
@misc{a712a3fd-86bb-4b54-a3e1-9df811e5e478,
  abstract     = {Introduction: It has traditionally been believed that early repolarization (ER) is benign. Significant association between ER and sudden cardiac arrest due to idiopathic ventricular fibrillation was recently found in a large cohort of adult survivors of sudden cardiac arrest. In some prior studies, unexplained syncope has been linked to risk of sudden death, but the mechanisms remain speculative.We assessed herein the prevalence of ER in children referred to our center for unexplained syncope. Methods: We evaluated retrospectively electrocardiograms from such children (n = 29; mean age, 12.1 years; range, 7-18 years) for presence of ER, which was defined as an elevation of the QRS-ST junction (J-point) in at least 2 leads of at least 1 mm (0.1 mV) above the baseline level. The anterior precordial leads (V1-V3) were excluded from the analysis to avoid inclusion of patients with right ventricular dysplasia or Brugada syndrome. Agematched children (n = 33; mean age, 12.3 years; range, 7-16 years) with noncardiac chest pain were included as controls. Results: Early repolarization was detected in 45% (13/29) of children with unexplained syncope vs 24% (8/33) in the chest pain group. Among children with syncope, ER was far more frequent in males than in females (8/12 vs 5/ 17, respectively). Echocardiography showed normal functional and structural findings in all children. Conclusion: In this relatively small-scale retrospective study of children with unexplained syncope with otherwise normal cardiac findings, we found particularly among those of male gender a greater prevalence of ER than in controls (noncardiac chest pain).With view to earlier findings of Haisaguerre et al (NEJM 2008), this intriguing association warrants further prospective studies addressing its precise clinical implication and underlying mechanisms.},
  author       = {I. Fernlund, Eva and Liuba, Petru},
  issn         = {1532-8430},
  keyword      = {child,faintness,repolarization,acute leukemia,male,prevalence,noncardiac chest pain,heart arrest,adult,survivor,risk,sudden death,electrocardiogram,patient,Brugada syndrome,thorax pain,female,echocardiography,retrospective study,gender,prospective study,heart ventricle fibrillation,heart right ventricle dysplasia},
  language     = {eng},
  note         = {Conference Abstract},
  number       = {2},
  pages        = {10--10},
  publisher    = {Elsevier},
  series       = {Journal of Electrocardiology},
  title        = {Early repolarization in children with unexplained syncope},
  url          = {http://dx.doi.org/10.1016/j.jelectrocard.2010.12.031},
  volume       = {44},
  year         = {2011},
}