Abstract :
J-wave syndromes refer to a group of conditions of inherited
arrhythmia disorders that can present with sudden cardiac death
due to polymorphic ventricular arrhythmias (1).
In some cases, the only clue to the diagnosis of these
infrequent conditions is surface electrocardiogram (ECG) (2). One
important point that all physicians should keep in mind is that only
the presence of the ECG pattern does not constitute the syndrome
(2). Several individuals will develop the ECG pattern (either
spontaneously or upon certain clinical conditions), and their risk
of sudden death may not differ from their counterparts without the
ECG manifestation.
The most commonly investigated and extensively reported
J-wave syndromes in the literature are Brugada syndrome (BrS)
(3) and early repolarization syndrome (ErS) (2). Both can affect
young individuals with no prior history of cardiovascular disease,
can coexist with “apparently” normal hearts (on initial cardiac
screening including echocardiogram), and are characterized
by J-point elevation (1-3). The morphology of the ST-segment
and T-wave following the J-point elevation helps physicians to
electrocardiographically differentiate one from the other (4). A
consensus on BrS (3) has classified the type of ECG phenotypes
into two variants (type-1 or “coved” and type-2 or “saddleback”),
and a more recent consensus on ErS (2) has characterized the
early repolarization pattern into “malignant” (more frequently
associated with ErS) and “benign” (frequently seen in healthy
individuals and athletes), which could be considered as a variant
of normality.
