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Early repolarization: an evolving concept for the past 70 years

Biasco, Luigi; Cristoforetti, Yvonne; De Backer, Ole; Castagno, Davide; Giustetto, Carla; Orzan, Fulvio; Gaita, Fiorenzo

Journal of Cardiovascular Medicine: January 2016 - Volume 17 - Issue 1 - p 4–10
doi: 10.2459/JCM.0000000000000276
Electrocardiography
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For more than 70 years, early repolarization has been considered to be a common normal variant. In the general population, the prevalence ranges between 5 and 13%, and in athletes, a rising trend is observed from 20 to 90%. Nevertheless, from the latter half of the 1990s, a growing number of case reports, series, observational and prospective studies reported that the presence of various electrocardiographic patterns attributed to early repolarization may constitute a potential marker for the increased risk of sudden death in otherwise normal individuals, casting a dark shadow on this ECG peculiarity. This review provides a historical summary of the evolution of the concept of early repolarization from its original description to the latest works and a guide to help physicians in evaluating individuals with this common electrocardiographic pattern.

aDivision of Cardiology, Department of Medical Science, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy

bThe Heart Centre, Rigshospitalet, Copenhagen, Denmark

Correspondence to Luigi Biasco, Division of Cardiology, Department of Medical Science, Città della Salute e della Scienza Hospital, University of Turin, C.so Bramante 88, 10126. Torino, Italy Tel: +39 011 6335571; fax: +39 011 6336769; e-mail: luigi.biasco@gmail.com

Received 11 November, 2014

Revised 7 January, 2015

Accepted 5 February, 2015

© 2016 Italian Federation of Cardiology. All rights reserved.