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Concept
Benign early repolarization
Summary
Benign early repolarization also known as early repolarization (abbr.: BER) is found on ECG in about 1% of those with chest pain. It is diagnosed based on an elevated J-point / ST elevation with an end-QRS notch or end-QRS slur and where the ST segment concave up. It is believed to be a normal variant.
Benign early repolarization that occurs as some patterns is associated with ventricular fibrillation. The association, revealed by research performed in the late 2000s, is very small.
Benign early repolarization, very prevalent in younger people and healthy male athletes, can be divided into 3 subtypes:
Type 1 – BER pattern seen in lateral precordial leads.
Type 2 – BER pattern seen in inferior or inferolateral leads.
Type 3 – BER pattern seen globally (inferior, lateral, right precordial leads).
Research in the late 2000s has linked this finding when found as some patterns to ventricular fibrillation, particularly in those who have fainted or have a family history of sudden cardiac death. Although there is a significant relationship between ventricular fibrillation and some early repolarization's patterns, the overall lifetime occurrence of idiopathic ventricular fibrillation is exceptionally rare. There has also been an association between early repolarization and short QT syndrome.
Male gender
J-point and horizontal or descending / downsloping ST segment (especially in inferior leads)
Elevation of ST segment by 2 mm
Elevation of a J-wave by 0.2 mV or more
J-point distribution globally
QRS longer than 110 ms
Longer duration of J wave, more than 60 ms
On an electrocardiogram (EKG or ECG), benign early repolarization may produce an elevation of the J-point and ST segment in 2 or more leads, similar to that observed in heart attacks (myocardial infarction). However, with benign early repolarization, the ST segment is usually concave up, rather than concave down (as with heart attacks), and there is a notable absence of reciprocal changes suggestive of ischemia on the EKG.
Official source
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