Does Early Repolarization Affect the Risk of Death and Ventricular Arrhythmias?

Early repolarization (ER) pattern, defined as J-point elevation of ≥1 mm in ≥2 contiguous inferior and/or lateral electrocardiography (ECG) leads, is a common finding, with a prevalence of approximately 6% in the adult population.^, ER has long been considered a benign phenomenon, as most affected individuals — typically young males and athletes — have a very low incidence of sudden cardiac death.^,

However, a pivotal study by Haïssaguerre et al. demonstrated a significantly higher occurrence of ER (31%) in patients with idiopathic ventricular fibrillation (VF) compared to controls (5%). Subsequent studies confirmed an association between ER and malignant ventricular arrhythmias (VA) in patients without structural heart disease.^, Additionally, ER has been linked to adverse outcomes in patients with primary electrical disorders such as long QT syndrome and Brugada syndrome.^,

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