J wave, QRS slurring, and ST elevation in athletes with cardiac arrest in the absence of heart disease marker of risk or innocent bystander?

Riccardo Cappato, Francesco Furlanello, Valerio Giovinazzo, Tommaso Infusino, Pierpaolo Lupo, Mario Pittalis, Sara Foresti, Guido De Ambroggi, Hussam Ali, Elisabetta Bianco, Roberto Riccamboni, Gianfranco Butera, Cristian Ricci, Marco Ranucci, Antonio Pelliccia, Luigi De Ambroggi

Research output: Contribution to journalArticlepeer-review


Background-QRS-ST changes in the inferior and lateral ECG leads are frequently observed in athletes. Recent studies have suggested a potential arrhythmogenic significance of these findings in the general population. The aim of our study was to investigate whether QRS-ST changes are markers of cardiac arrest (CA) of unexplained cause or sudden death in athletes. Methods and Results-In 21 athletes (mean age 27 years; 5 women) with cardiac arrest or sudden death the ECG recorded before or immediately after the clinical event was compared with the ECG of 365 healthy athletes eligible for competitive sport activity. We measured the height of the J wave and ST elevation and searched for the presence of QRS slurring in the terminal portion of QRS. QRS slurring in any lead was present in 28.6% of cases and in 7.6% of control athletes (P=0.006). A J wave and/or QRS slurring without ST elevation in the inferior (II III and aVF) and lateral leads (V4 to V6) were more frequently recorded in cases than in control athletes (28.6% versus 7.9% P=0.007). Among those with cardiac arrest arrhythmia recurrences did not differ between the subgroups with and without J wave or QRS slurring during a median 36-month follow-up of sport discontinuation. Conclusions-J wave and/or QRS slurring was found more frequently among athletes with cardiac arrest/sudden death than in control athletes. Nevertheless, the presence of this ECG pattern appears not to confer a higher risk for recurrent malignant ventricular arrhythmias.

Original languageEnglish
Pages (from-to)305-311
Number of pages7
JournalCirculation: Arrhythmia and Electrophysiology
Issue number4
Publication statusPublished - Aug 2010


  • Athletes
  • Cardiac arrest
  • Early repolarization
  • Sudden death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

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