The Relationship Between Ischemic J Wave And Ventricular Arrhythmias In Patients With Acute ST Segment Elevation Myocardial Infarction

Objective:To study the relationship between ischemic J wave and ventricular tachyarrhythmias(VTAs)in patients with acute ST segment elevation myocardial infarction(STEMI).Methods:239 patients with STEMI(189 men and 50 women;mean age,64 ± 14 years)who had undergone percutaneous coronary intervention were retrospectively included in the current trial and assigned to J wave group(n = 77)and non-J wave group(n = 162)according to the appearance of J wave on the standard 12-lead electrocardiogram.Patient baseline characteristics,diseased arteries were observed and ventricular tachyarrhythmia events were evaluated.Then J wave group was divided into two subgroups(VTAs group and non-VTAs group)to compare the characteristics of J wave in each subgroup.Ischemic J wave on the standard 12-lead electrocardiogram was defined as J point elevation ? 1mm(0.1 mV)and duration ? 0.5mm(20ms)in at least 2 contiguous leads,manifesting as notching or slurring pattern.Ventricular tachyarrhythmia occurrence within 48 hours of infarction was monitored and recorded as the primary endpoint.Results:The incidence of ischemic J wave was 32.2%and was higher in male patients,and VTAs occurred in 19 patients(19/239,7.9%).The incidence of VTAs was 16.9%in the J wave group as compared with 3.7%in the non-J wave group(P<0.001).Prevalence of multiple-lead J wave in VTAs group was higher than that in non-VTAs group(46.2%vs 18.7%,P<0.05).Conclusions:In STEMI patients,the risk of VTAs was higher among those with J wave than those without J wave.J wave on multiple leads might be a predictor of malignant ventricular arrhythmias.