Invasive Electrophysiologic Studies Not Useful in Malignant Early Repolarization Syndrome

The malignant early repolarization syndrome consists of J-point elevation, slurring/notching of the terminal QRS complex, and clinical ventricular fibrillation (VF). Early repolarization without clinical VF is common, and it is unclear which of these patients are at particular risk for sudden cardiac death. To test whether invasive electrophysiology studies (EPS) would aid in assessing risk, researchers analyzed data from a European multicenter registry of malignant early repolarization, from which 81 individuals with malignant early repolarization underwent EPS.

All patients had recent clinical VF, yet in only 18 (22%) was VF inducible. Inducibility was not associated with maximal J-point elevation or J-wave location on electrocardiogram. D…