Benign early repolarization pattern: Is it really benign for children?

INTRODUCTION: Early repolarization (ER) is a common electrocardiographic (ECG) finding. Although it is known a benign phenomenon, recent studies have shown it to be an important marker of cardiac vulnerability, which can lead to sudden cardiac death. However, there are still conflicting data regarding the prognostic significance of ER in asymptomatic subjects, especially in children. The aim of this study was to investigate specific ECG markers that reflect ventricular repolarization in children with benign ER.
METHODS: The study group included 56 healthy children with a benign ER pattern on ECG and a control group was formed of 81 children with normal ECG. Benign ER pattern was defined as terminal QRS notching or slurring accompanied by rapidly ascending ST elevation (> 0.1 mV from baseline) in two or more leads. The ECG parameters of QT dis, QTc dis, Tpe dis, Tp-e/QT and Tp-e/QTc were evaluated at rest by a single experienced pediatric cardiologist blinded to the groups.
RESULTS: Higher Tp-e, Tp-e dis, Tp-e/QT and Tp-e/QTc measurements were determined in the study group than in the control group. There were no significant differences in the studied ECG parameters in respect of ER location (inferior, lateral, inferolateral), or the ER type (slurring, notching or both).
DISCUSSION AND CONCLUSION: These findings suggest that benign ER in children is associated with the risk of arrhythmogenesis through alterations in ventricular repolarization.