Abstract
Objective
To evaluate the prevalence of early polarization (ER) in a stable population and to
evaluate the prognostic significance of the association or absence of Q waves or T-wave
inversion (TWI).
Patients and Methods
In this retrospective study performed at the university-affiliated Palo Alto Veterans
Affairs Health Care Center from March 1, 1987, through December 31, 1999, we evaluated
outpatient electrocardiograms. Vital status and cause of death were determined in
all patients, with a mean ± SD follow-up of 7.6±3.8 years.
Results
Of the 29,281 patients, 87% were men and 13% were African American. Inferior or lateral
ER was present in 664 patients (2.3%): in inferior leads in 185 (0.6%), in lateral
leads in 479 (1.6%) , and in both inferior and lateral leads in 163 (0.6%). Only when
Q waves or TWI accompanied ER was there an increased risk of cardiovascular death
(Cox proportional hazards regression model, 5.0; 95% confidence interval, 3.4-7.2;
P<.001).
Conclusion
Common patterns of ER without concomitant Q waves or TWI are not associated with increased
risk of cardiovascular death; however, when either occurs with ER, there is a hazard
ratio of 5.0. These findings confirm that ER is a benign entity; however, the presence
of Q waves or TWI with ER is predictive of increased cardiovascular death.
Abbreviations and Acronyms:
CV (cardiovascular), ECG (electrocardiogram), ER (early repolarization), HR (hazard ratio), TWI (T-wave inversion), VA (Veterans Administration)To read this article in full you will need to make a payment
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Article Info
Footnotes
For editorial comment, see page 610
Potential Competing Interests: Dr Froelicher is co-owner and Chief Medical Officer of Cardea Associates, Inc, Woodinville, WA, developers of software and hardware for screening for cardiovascular risk.
Identification
Copyright
© 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
