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open access

Vol 15, No 1 (2008)
Review Article
Submitted: 2013-01-14
Published online: 2007-12-17
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Early repolarization variant: Epidemiological aspects, mechanism, and differential diagnosis

Andrés Ricardo Pérez Riera, Augusto Hiroshi Uchida, Edgardo Schapachnik, Sérgio Dubner, Li Zhang, Celso Ferreira Filho, Celso Ferreira
DOI: 10.5603/cj.21631
·
Cardiol J 2008;15(1):4-16.

open access

Vol 15, No 1 (2008)
Review articles
Submitted: 2013-01-14
Published online: 2007-12-17

Abstract

Early repolarization variant (ERV or ERPV) is a enigmatic electrocardiographic phenomenon, characterized by prominent J wave and ST-segment elevation in multiple leads. Recently, there has been renewed interest in ERV because of similarities to the arrhythmogenic Brugada syndrome (BrS). Not much is known about the epidemiology of ERV and several studies have reported that this condition is associated with a good prognosis. Both syndromes exhibit some similarities including the ionic underlying mechanism, the analogous responses to changes in heart rate and autonomic tone, sympathicomimetics (isoproterenol test) as well as in sodium channel and beta-blockers. These observations raise the hypothesis that ERV may be not as benign as traditionally believed. Additionally, there are documents showing that ST-segment height in the man is greatly influenced by central sympathetic nervous activity, both at baseline and during physiologic and pharmacological stress.
Central sympathetic dysfunction regularly results in multilead ST-segment elevation or J wave that decreases or below isoelectric baseline during low dose isoproterenol infusion.
In this review, we describe the characteristics of ERV and the main differences with acute pericarditis, acute myocardial infraction/injury and Brugada syndrome. (Cardiol J 2008; 15: 4-16)

Abstract

Early repolarization variant (ERV or ERPV) is a enigmatic electrocardiographic phenomenon, characterized by prominent J wave and ST-segment elevation in multiple leads. Recently, there has been renewed interest in ERV because of similarities to the arrhythmogenic Brugada syndrome (BrS). Not much is known about the epidemiology of ERV and several studies have reported that this condition is associated with a good prognosis. Both syndromes exhibit some similarities including the ionic underlying mechanism, the analogous responses to changes in heart rate and autonomic tone, sympathicomimetics (isoproterenol test) as well as in sodium channel and beta-blockers. These observations raise the hypothesis that ERV may be not as benign as traditionally believed. Additionally, there are documents showing that ST-segment height in the man is greatly influenced by central sympathetic nervous activity, both at baseline and during physiologic and pharmacological stress.
Central sympathetic dysfunction regularly results in multilead ST-segment elevation or J wave that decreases or below isoelectric baseline during low dose isoproterenol infusion.
In this review, we describe the characteristics of ERV and the main differences with acute pericarditis, acute myocardial infraction/injury and Brugada syndrome. (Cardiol J 2008; 15: 4-16)

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Keywords

early repolarization variant; pericarditis; acute coronary syndrome; Brugada syndrome; differential diagnosis

About this article
Title

Early repolarization variant: Epidemiological aspects, mechanism, and differential diagnosis

Journal

Cardiology Journal

Issue

Vol 15, No 1 (2008)

Article type

Review Article

Pages

4-16

Published online

2007-12-17

Page views

623

Article views/downloads

2132

DOI

10.5603/cj.21631

Bibliographic record

Cardiol J 2008;15(1):4-16.

Keywords

early repolarization variant
pericarditis
acute coronary syndrome
Brugada syndrome
differential diagnosis

Authors

Andrés Ricardo Pérez Riera
Augusto Hiroshi Uchida
Edgardo Schapachnik
Sérgio Dubner
Li Zhang
Celso Ferreira Filho
Celso Ferreira

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