ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2026
Electrocardiographic predictor of sudden cardiac death in patient with early repolarization pattern: a systematic review & meta-analysis.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEarly Repolarization Pattern (ERP) was independently associated with higher risk of Sudden Cardiac Death (SCD). Risk stratification using Electrocardiographic (ECG) characteristics in ERP patients remains challenging. Previous studies have proposed several markers. However, their prognostic value has been inconsistent across studies. This study aims to synthesize the current evidence on ECG predictors of SCD in patients with ERP.
methodsWe extracted data from PubMed, ScienceDirect, and Cochrane Library. Inclusion criteria include cohort or case-control studies in ERP patients with SCD outcome along with measured ECG parameters. The primary endpoint was life-threatening arrhythmia resulting in SCD. We assessed the quality of studies using the Newcastle-Ottawa Scale (NOS). Data will be presented as Odds Ratio (OR) with 95% Confidence Interval (CI).
resultsFrom 9 included studies (24679 patients), the risk of SCD was higher when ERP was present in inferior and inferolateral lead (OR = 2.15, 95% CI = 1.77–2.62, p < 0.00001; OR = 4.26, 95% CI = 2.60–6.99, p < 0.00001; respectively). Similarly, an ERP amplitude > 0.2 mV was associated with a higher risk of SCD, along with horizontal elevation, slurred, and notched morphology (p < 0.05). However, there is no predictive value on lateral lead distribution and ascending morphology. All studies were considered good quality by NOS.
conclusionThis study demonstrated that several ECG markers are significantly associated with an increased risk of SCD in patients with ERP. Although these markers may contribute to the identification of higher-risk phenotypes, their clinical utility for risk stratification requires further validation.
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