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World J Cardiol. Aug 26, 2015; 7(8): 466-475
Published online Aug 26, 2015. doi: 10.4330/wjc.v7.i8.466
Early repolarization syndrome: A cause of sudden cardiac death
Abdi Ali, Nida Butt, Azeem S Sheikh
Abdi Ali, Nida Butt, Core Medical Trainees, Wrexham Maelor Hospital, Wrexham, Wales LL13 7TZ, United Kingdom
Azeem S Sheikh, Department of Cardiology, Wrexham Maelor Hospital, Wrexham, Wales LL13 7TZ, United Kingdom
Author contributions: All authors contributed to this manuscript.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Azeem S Sheikh, BSc, MBBS, FCPS, MRCP, Specialist Registrar in Cardiology, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham, Wales LL13 7TZ, United Kingdom. drazeemsheikh@hotmail.com
Telephone: +44-7969-686217 Fax: +44-1978-725134
Received: March 16, 2015
Peer-review started: March 17, 2015
First decision: April 10, 2015
Revised: May 18, 2015
Accepted: June 1, 2015
Article in press: June 2, 2015
Published online: August 26, 2015
Core Tip

Core tip: Early repolarization syndrome (ERS), demonstrated as J-point elevation on an electrocardiograph, was formerly thought to be a benign entity, but the recent studies have demonstrated that it can be linked to a higher risk of ventricular arrhythmias and sudden cardiac death. The prevalence of ERS varies between 3% and 24%, depending on age, sex and J-point elevation (0.05 mV vs 0.1 mV) being the main determinants. ERS patients are sporadic and they are at a higher risk of having recurrent cardiac events. Implantable cardioverter-defibrillator implantation and isoproterenol are the suggested therapies in this set of patients. On the other hand, asymptomatic patients with ERS are common and have a better prognosis. The risk stratification in asymptomatic patients with ERS still remains a grey area. This review provides an outline of the up-to-date evidence associated with ERS and the risk of life - threatening arrhythmias. Further prospective studies are required to elucidate the mechanisms of ventricular arrhythmogenesis in patients with ERS.