Epidemiology of early repolarization pattern in an adult general population

Acta Cardiol. 2020 Dec;75(8):713-723. doi: 10.1080/00015385.2019.1667623. Epub 2019 Sep 17.


Background: Early repolarization pattern (ERP) is a frequent finding in asymptomatic subjects with controversial implications regarding to its prognosis. This study aims to estimate the prevalence of ERP and its association with sociodemographic characteristics and cardiovascular risk factors among the adult population in the Southern Cone of Latin America.Methods: A sub-sample of 5398 participants of the CESCAS I study was included in the present analysis. ERP was defined as a J peak ≥0.1 mV in two or more contiguous leads with an end-QRS notch or slur on the downslope of a prominent R-wave.Results: The global prevalence of ERP was 8.1%; 11.1% in men and 5.6% in women. The prevalence in women increased with age (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.5-4.2, at >65 years, p < 0.001), current cigarette smoking (OR 1.4, 95%CI 1.0-2.0, p = 0.045) and hypercholesterolaemia (OR 1.4, 95%CI 1.0-2.0, 0 p = 0.036). Conversely, in men, ERP prevalence decreased with age (OR 0.5, 95%CI 0.3-0.9, at >65 years, p = 0.01) and obesity (OR 0.6, 95%CI 0.4-0.8, p = 0.006). We found an increasing ERP prevalence with a higher Sokolow-Lyon index in both sexes (p < 0.001). Inferior location was found in 67.9% of cases, and the most common ERP type was a "slurring" appearance without ST elevation (76.3%).Conclusions: We found an overall prevalence of ERP of 8.1% and a robust association of ERP with normal BMI and higher Sokolow-Lyon index in men and with hypercholesterolaemia, current cigarette smoking and higher Sokolow-Lyon index in women.

Keywords: Early repolarization pattern; Idiopathic ventricular fibrillation; J-point elevation; electrocardiography; epidemiology; sudden cardiac death.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Argentina / epidemiology
  • Arrhythmias, Cardiac / complications*
  • Arrhythmias, Cardiac / epidemiology
  • Arrhythmias, Cardiac / physiopathology
  • Death, Sudden, Cardiac / epidemiology*
  • Death, Sudden, Cardiac / etiology
  • Electrocardiography*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Population Surveillance*
  • Prevalence
  • Prognosis
  • Retrospective Studies
  • Risk Factors