57-06: Prevalence of Early Repolarization pattern in 12 lead electrocardiogram: a population based study

Abstract

Background: Early Repolarization pattern (ERP) has been considered a benign finding. However, this has been recently challenged due to its association with idiopathic ventricular fibrillation. The exact prevalence and characterization in the Southern Cone of Latin America are unknown. Purpose: The main objective of the study was to determine the prevalence of ERP and its characteristics in Southern Cone of Latin America according to the last consensus (Macfarlane et al.). Methods: The study population consisted in subjects of the CESCAS I study. CESCAS I study is an observational prospective cohort study with a multistage probabilistic sample of 8000 participants aged 35–74 years from 4 cities representing the Southern Cone of Latin America designed to estimate the prevalence and distribution of and secular trends in major cardiovascular disease events and risk factors. In addition to undergoing standard resting 12-lead electrocardiography, the subjects completed a questionnaire regarding their health habits, known diseases, and medications. Biochemical and physical parameters were measured by a trained nurse. For the present analysis we use 5940 ECGs from 3 cities, we excluded 300 subjects for whom ECGs were missing or incomplete. We also excluded 242 subjects with bundle branch block, Wolf–Parkinson–White pattern, atrial fibrillation, and cardiac pacing. Two trained cardiologists, blinded to clinical data, independently assessed all ECGs and recorded the presence of ERP. A third cardiologist judged the disagreements. Interobserver reliability was evaluated. Results: A total of 5398 ECGs were analysed with a male proportion of 41.3% and a mean age of 54.3 ± 10.7 years. The inferior location was found in 67.94% of cases (267/5398). The most common type was the “slurring” appearance without ST elevation represented 76.34% of cases. There was an important strength of agreement between the two initial interpreters (k= 0.89, proportion agreement 86.46%). In the multivariable regression model independent predictors of ERP were body mass index (OR 0.97 95% CI 0.95; 0.99), male sex (OR 1.47 95% CI 1.19; 1.81) and Sokolov Index (OR 1.04 95% CI 1.02; 1.06), p vale < 0.01. Conclusions: Consistent with published estimates ranging from 1% to 13% we found an overall prevalence of ERP of 8.1%. Male sex, lower body mass index and lower Sokolov Index were independently associated with the presence of ERP. Figure 1. Weighted prevalence of ERP by age and gender.