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World J Cardiol. Aug 26, 2016; 8(8): 447-455
Published online Aug 26, 2016. doi: 10.4330/wjc.v8.i8.447
12-lead electrocardiogram features of arrhythmic risk: A focus on early repolarization
Caterina Rizzo, Francesco Monitillo, Massimo Iacoviello
Caterina Rizzo, Francesco Monitillo, School of Cardiology, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy
Massimo Iacoviello, Cardiology Unit, Department of Cardiothoracic, Policlinic University Hospital, 70124 Bari, Italy
Author contributions: All authors contributed to this manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Massimo Iacoviello, MD, PhD, FESC, FANMCO, Cardiology Unit, Department of Cardiothoracic, Policlinic University Hospital, Piazza Giulio Cesare 11, 70124 Bari, Italy. massimo.iacoviello@cardio.uniba.it
Telephone: +39-80-5478622 Fax: +39-80-5478796
Received: April 28, 2016
Peer-review started: April 30, 2016
First decision: May 17, 2016
Revised: June 6, 2016
Accepted: July 11, 2016
Article in press: July 13, 2016
Published online: August 26, 2016
Processing time: 115 Days and 15.7 Hours
Abstract

The 12-lead electrocardiogram (ECG) is still the most used tool in cardiology clinical practice. Considering its easy accessibility, low cost and the information that it provides, it remains the starting point for diagnosis and prognosis. More specifically, its ability to detect prognostic markers for sudden cardiac death due to arrhythmias by identifying specific patterns that express electrical disturbances of the heart muscle, which may predispose to malignant arrhythmias, is universally recognized. Alterations in the ventricular repolarization process, identifiable on a 12-lead ECG, play a role in the genesis of ventricular arrhythmias in different cardiac diseases. The aim of this paper is to focus the attention on a new marker of arrhythmic risk, the early repolarization pattern in order to highlight the prognostic role of the 12-lead ECG.

Keywords: Ventricular repolarization; Cardiovascular diseases; Arrhythmic risk; Early repolarization; Arrhythmia

Core tip: By identifying specific patterns which are an expression of ventricular repolarization alterations, the 12-lead electrocardiogram plays an important role in the diagnosis of electrical disturbances and in the risk stratification of death due to arrhythmias. This review focuses the attention on the new early repolarization marker of arrhythmic risk and its prognostic implications.