J-Point Elevation in Survivors of Primary Ventricular Fibrillation and Matched Control SubjectsIncidence and Clinical Significance
Raphael Rosso, MD*,
Evgeni Kogan, MD*,
Bernard Belhassen, MD*,
Uri Rozovski, MD*,
Melvin M. Scheinman, MD ,
David Zeltser, MD*,
Amir Halkin, MD*,
Arie Steinvil, MD*,
Karin Heller, MD*,
Michael Glikson, MD ,
Amos Katz, MD and
Sami Viskin, MD*,*
* Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel
Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Soroka Medical Center and Ben Gurion University, Beer-Sheva, Israel
University of California San Francisco, San Francisco, California
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Figure 1 Electrocardiogram of a 45-Year-Old Man in the Ventricular Fibrillation Group
This patient was eventually diagnosed as Brugada syndrome. Note that leads V1 to V3 do not show any ST-segment elevation. In contrast, the J-point elevation in leads II, III, and aVF is obvious. Note also the ventricular extrasystoles with short coupling interval. The very short coupling interval is best appreciated in lead V2.
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Figure 2 J-Point Elevation and R-Wave Slurring
A and B show the electrocardiograms (leads I to aVF) of 2 male subjects with idiopathic ventricular fibrillation, whereas C shows the electrocardiogram of a healthy male athlete. The lower panel shows enlargements of the respective electrocardiograms. A1 demonstrates J-point elevation (arrows). B1 demonstrates slurring of the QRS (arrowhead). C1 demonstrates J-point elevation (arrows).
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Figure 4 Distribution of J Waves Among Patients With Idiopathic VF, Matched Control Subjects, and Healthy Athletes
The bars show the percentage of individuals with J-point elevation in each of the 3 patient groups. The y axis denotes the percentage of patients with J-point elevation in any lead. The partition of each bar demonstrates the distribution of J-point elevation in the different leads (the numbers within the bars exceed 100%, because some patients had J-point elevation in more than 1 group of leads). VF = ventricular fibrillation.
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