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• W1968417376 abstract "Early repolarization (ER) is a common electrocardiographic pattern that usually carries a benign prognosis, but has been shown to be associated with increased cardiac morbidity and mortality in several at-risk cardiac populations. ER portends a worse prognosis when it persists with exercise or develops in recovery. We have recently shown that in patients with long QT syndrome (LQTS) types 1 and 2, ER ≥2 mm is the strongest independent predictor of symptom status. Changes in ER with exercise or in recovery may help further risk stratify this population. We identified patients with genotype positive and genotype negative (Schwartz score ≥3.5) LQTS followed in the London inherited arrhythmia clinic who had undergone ECG treadmill stress testing. Symptom status was defined by a history of cardiac syncope, documented polymorphic ventricular tachycardia, or resuscitated sudden cardiac arrest. ER was defined as QRS slurring/notching and ≥1mm J-point elevation in ≥2 contiguous leads, excluding the anterior precordial leads. Major ER was defined as ≥2mm J-point elevation. Changes in ER pattern were measured at rest, peak exercise, and 4 minutes into recovery. Persistent ER was defined as no change in the amount of J-point elevation during exercise or in recovery. Diminishing ER pattern was defined as a change of ≥1mm of J-point elevation. One-hundred and eight genotype positive (65 LQTS1, 42 LQTS2, 1 LQTS3) and 9 genotype negative patients were identified (n=117, 66 female, age 40 ± 18 years, range 10-82). Thirty patients (26%) had a history of symptoms. Fifty-four patients (46%) had ER at rest. Twenty-eight of these patients (52%) demonstrated persistent ER throughout the exercise test, and 23 patients (43%) demonstrated diminishing ER pattern with exercise. Of these patients, 9 (32%) and 6 (26%) had a history of symptoms, respectively (p = 0.634). Twenty-six patients had major ER at rest, of which 20 demonstrated persistent ER and 6 diminished ER with exercise. Seven (35%) and 3 (50%) patients were symptomatic, respectively (p=0.508). No patients developed ER during exercise testing or during the recovery period. In this modest-sized LQTS population, there was no difference in symptom status between patients with diminishing and persistent ER during exercise stress testing, regardless of the baseline degree of ER. Furthermore, ER was not provoked by exercise or during recovery in this population." @default.
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• W1968417376 date "2014-10-01" @default.
• W1968417376 modified "2023-10-16" @default.
• W1968417376 title "IMPACT OF EXERCISE AND RECOVERY ON EARLY REPOLARIZATION IN LONG QT SYNDROME" @default.
• W1968417376 doi "https://doi.org/10.1016/j.cjca.2014.07.740" @default.
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