Risk stratification of the J wave syndrome

Atsuyuki Watanabe, Hiroshi Morita

Research output: Chapter in Book/Report/Conference proceedingChapter


Appearance of a J wave is a potent risk for idiopathic ventricular fibrillation (VF). The incidence of inferolateral J wave is higher in patients with idiopathic VF than that in control subjects. Patients having a higher and widespread J wave with horizontal/descending ST segments are at high risk for arrhythmic events (malignant early repolarization (ER)), and it is associated with arrhythmic storm. J wave dynamicity, fragmented QRS, and T wave abnormality will be even more high-risk signs in patients with malignant ER. Occurrence of short coupled premature ventricular contractions can be a precursor of VF and sudden death. Patients who have experienced aborted cardiac arrest or ventricular tachyarrhythmias should receive an implantable cardioverter defibrillator. Cohort studies have shown that inferolateral J wave is also a risk marker for the cardiovascular and arrhythmic events. High and widespread J wave is also a risk for the arrhythmic events in general population, but the occurrence of idiopathic VF is very rare. The incidence of the idiopathic VF will be 90:100,000 in persons with a tall J wave with a horizontal/descending ST segment. The existence of J wave will increase the risk of VF during acute ischemia or in patients with structural heart diseases. In patients with inherited arrhythmic syndrome, J wave also increases the risk of VF.

Original languageEnglish
Title of host publicationEarly Repolarization Syndrome
Subtitle of host publicationEtiology and Therapeutics
PublisherSpringer Singapore
Number of pages15
ISBN (Electronic)9789811033797
ISBN (Print)9789811033780
Publication statusPublished - Aug 17 2017

ASJC Scopus subject areas

  • Medicine(all)


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