The syndrome of early repolarization of ventricles

The syndrome of early repolarization of the ventricles is not true according to the clinical and functional classification of cardiology for any cardiac arrhythmias. Electrocardiographic phenomenon has the typical pattern of registered graphic record but is not considered a disease. Sometimes the changes are not regarded as a pathology. They are inherent in healthy people and do not require treatment.

The danger lies in the unpredictability of the further physiological abnormalities in the heart muscle, as well as in combination of the syndrome of early repolarization of the ventricles with severe heart disease. Therefore, its detection in ECG requires careful examination by a cardiologist and observation.

The prevalence of ECG changes

According to statistics, cardiac studies, the prevalence typical for the syndrome of changes ranges from 1 to 8.2%. Diagnosed in young people, children and adolescents. In the elderly is rare.

The connection with hypertrophy of the myocardium in athletes and individuals who perform physically demanding work. Often diagnosed in black people and African Americans.

What changes in the heart cause a syndrome?

Normal repolarization is caused by the predominant process of exit of potassium from the cells over the inflow of sodium ions inside. Thanks to what from the outside appears a positive charge, inside negative. This mechanism of termination of the excitation of one fiber propagates in the form of a pulse at neighboring sites according to the type of chain reaction, it corresponds to the diastolic phase.

Repolarization of the myocardium prepares for the next systole provides the excitability of muscle fibers. From its quality and duration depends on the phase of contraction (depolarization) of the heart. These electrical changes have direction. Beginning in the septum between the ventricles, then spread into the myocardium first left, then right ventricles.

The reasons for the extraordinary repolarization, in addition to additional detours impulse, I think:

• neuroendocrine disease (the most characteristic in childhood);
• the increasing incidence during sleep and in the predominance of the influence of the vagus nerve, points to the importance of the autonomic nervous system;
• excessive physical load;
• hypercholesterolemia in the blood;
• the use of drugs from the group of α2-agonists in the treatment of patients (Gemiton, Clonidine, Catapresan, Clonidine);
• cardiomyopathy hypertrophic type;
• congenital or acquired heart defects, including disrupted the structure of the conduction system);
• the change in the structure of connective tissue systemic diseases.

Types and criteria of premature repolarization of the ventricles

The main criteria of ECG-pattern in the diagnosissyndrome are:

1. An upward shift of the ST interval. Usually it is not strictly horizontal direction and smoothly into the rising knee of the tooth T. the Sharp rise indicates that the process of necrosis in the infarct expressed dystrophy, intoxication with digitalis, pericarditis. Express repolarization gives rise interval of not more than 3 mm.
2. Tall T wave with a wide base (to be distinguished from hyperkalemia, and ischemia).
3. The "notch" in the descending Department R.

One detects similar violations?

For premature repolarization is characterized by a manifestation on the background:

• overload of the left ventricle in hypertensive crisis, acute circulatory failure;
• ventricular arrythmia;
• supraventricular tachyarrhythmia;
• ventricular fibrillation;
• in adolescence, with the active sexual maturation of the child;
• in children with problems of placental circulation during pregnancy, congenital malformations;
• individuals involved in sports for a long time.