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CLINICAL STUDY: ELECTROCARDIOGRAPHY STUDY

Prevalence of male and female patterns of early ventricular repolarization in the normal ECG of males and females from childhood to old age

Borys Surawicz, MD, MACC^*,* and Sanjay R. Parikh, MD, FACC

^* Indiana Heart Institute, Indianapolis, Indiana, USA
The Care Group, St. Vincent Hospital, Indianapolis, Indiana, USA

Manuscript received October 31, 2001; revised manuscript received July 21, 2002, accepted August 20, 2002.

^* Reprint requests and correspondence: Dr. Borys Surawicz, 8333 Naab Road, Suite 400, Indianapolis, Indiana 46260, USA.
tscott{at}thecaregroup.com

OBJECTIVES: This study was designed to establish the cause of electrocardiographic (ECG) pattern differences between genders.

BACKGROUND: The male and female patterns of early ventricular repolarization in normal ECGs differ from each other. The male pattern displays a higher J-point amplitude and increased ST angle. The distribution of these patterns between genders has not been studied.

METHODS: Normal ECGs of 529 males and 544 females, age 5 to 96 years, were subdivided into nine age groups in each gender. We designated the pattern as female if the J point was <0.1 mV in each of the leads V₁ to V₄, and as male if the J point was 0.1 mV and the ST angle 20° in at least one of the V₁ to V₄ leads; the pattern was indeterminate if the J point was 0.1 mV and the ST angle was <20°.

RESULTS: Distribution of patterns was significantly different between genders (p < 0.001). In females, the patterns were distributed similarly from puberty to advanced age with about 80% prevalence of the female pattern. In males, the male pattern prevalence increased at puberty, reached 91% in the age group of 17 to 24 years and declined gradually with advancing age to 14% in the oldest males. The prevalence of indeterminate pattern was about 10% in both genders. Patterns were unchanged in 95% of 493 subjects who had ECGs recorded at separate times or at different heart rates.

CONCLUSIONS: Gender differences in early ventricular repolarization were caused by age-dependent changes in prevalence of the male pattern.

Abbreviations and Acronyms   ANOVA   analysis of variance   ECG   electrocardiogram/electrocardiographic   TdP   torsade de pointes

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