Benign clinical significance of J-wave pattern (early repolarization) in highly trained athletes

Filippo M Quattrini, Antonio Pelliccia, Riccardo Assorgi, Fernando M DiPaolo, Maria Rosaria Squeo, Franco Culasso, Vincenzo Castelli, Mark S Link, Barry J Maron
Heart Rhythm: the Official Journal of the Heart Rhythm Society 2014, 11 (11): 1974-82

BACKGROUND: J wave/QRS slurring (early repolarization) on 12-lead ECG has been associated with increased risk for ventricular fibrillation in the absence of cardiovascular (CV) disease.

OBJECTIVE: The purpose of this study was to assess the prevalence and clinical significance of J wave/QRS slurring in a large population of competitive athletes.

METHODS: Seven hundred four athletes (436 males [62%], age 25 ± 5 years) free of CV disease who had engaged in 30 different sports were examined. Serial clinical, ECG, and echocardiographic evaluations were available over 1 to 18 years of follow-up (mean 6 ± 4 years).

RESULTS: J wave was found in 102 athletes (14%) and was associated with QRS slurring in 32 (4%). It was found most commonly in anterior, lateral, and inferior leads (n = 73 [72%]), occasionally in lateral leads (n = 26 [25%]), and rarely in inferior leads (n = 3 [3%]). Most of 102 athletes (n = 86 [84%]) also showed ST-segment elevation. J wave/QRS slurring was associated with other training-related ECG changes (ie, increased R/S-wave voltages in 76%) and left ventricular (LV) morphologic remodeling (LV mass 199 ± 48 g vs 188 ± 56 g, P <.05). During follow-up, no athlete with J wave experienced cardiac event or ventricular tachyarrhythmias, or developed structural CV disease.

CONCLUSION: In athletes, early repolarization pattern usually is associated with other ECG changes, such as increased QRS voltages and ST-segment elevation, as well as LV remodeling, suggesting that it likely represents another benign expression of the physiologic athlete's heart. J wave (early repolarization) is common in highly trained athletes and does not convey risk for adverse cardiac events, including sudden death or tachyarrhythmias.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"