Introduction: Early Repolarization (ER) has recently been associated with an increased risk of sudden cardiac death. ECG machines detect ER using algorithms based on ST-segment elevation, while the ER-pattern associated with SCD is based on J-wave morphology. As automatic readings of ”ER” may raise unwarranted concern and create liability issues, we investigated its prognostic implication in a large racially diverse inner-city population.
Methods: An ECG database from a tertiary medical center serving an urban population containing n=900,000 records was interrogated for automated in- and outpatient resting ECGs. Only the first recorded ECG per individual was included. ECG’s recorded during ACS and in individuals <18 years old were excluded. Outcomes were assessed by searching hospital records and the Social Security Death Index.
Results: Baseline characteristics are shown in Table 1. ER prevalence differed significantly between racial subgroups (p-ANOVA <0.001) and was more common in African Americans. When controlling for age using regression analysis, there was no significant difference in mortality between subjects with vs. without ER regardless of race or gender (p>0.10 for all).
Conclusions: Automated ECG reading of “ER” does not portend an increased risk of death regardless of race or gender. Therefore, individuals with such readings should be reassured.