Clinical aspects of the early repolarization syndrome: a 2011 update.

Recent studies suggest that the electrocardiographic (ECG) finding of J-point ST-elevation, the early repolarization syndrome, is not as benign as earlier believed. Three important articles published in 2008/2009 suggest that this finding in the inferolateral leads of the ECG may be representing a risk for subsequent ventricular fibrillation. Although these retrospective studies do justify a careful evaluation of persons with this electrocardiographic pattern, especially of those with syncope or ventricular arrhythmias and/or family history of sudden cardiac death, it seems to be unjustified to consider it today to be a marker for high risk for sudden cardiac deaths in a general population. Even in athletes, early repolarization was found to increase only minimally their arrhythmic risk. In spite of certain similarities with the Brugada syndrome, their association is far from being proved. Prospective studies and further electrophysiological and genetic information will help to clarify the clinical significance of this syndrome.