Relationship Between an Ischaemic J Wave Pattern and Ventricular Fibrillation in ST-Elevation Myocardial Infarction Patients

Luyao Zhang,* Shujuan Dong,* Wenbo Zhao, Jingchao Li, Luqian Cui, Yongmei Han, Yingjie Chu Department of Cardiology, Henan Provincial People’s Hospital, Zhengzhou, Henan Province, 450003, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yingjie Chu Email Chuyingjie59@163.comBackground: This study determined the ischaemic J wave pattern associated with ventricular fibrillation (VF).Methods: A total of 262 patients diagnosed with ST-elevation myocardial infarction (STEMI) were recruited from October 2017 to September 2020. All data were collected and analysed, including baseline characteristics, electrocardiogram (ECG), coronary angiography (CAG), and examination outcomes.Results: There were 193 STEMI patients with J wave elevation but without an ischaemic J wave (NJ group) and 69 patients with an ischaemic J wave; the latter were then subgrouped into early repolarization pattern (ERP; n=62) and Brugada pattern groups (BrP [anteroseptal ERP]; n=7). Univariate and multivariate logistic regression analyses were used to clarify high-risk factors and characteristics of ischaemic J waves. Multivariate logistic regression analysis revealed that an ischaemic J wave (odds ratio [OR], 9.708; 95% CI, 2.570– 36.664; P=0.01) independently predicted VF. In the subgroup analysis, BrP (OR, 31.214; 95% CI, 3.949– 246.742; P=0.001), slur morphology of the ERP (OR, 8.15; 95% CI, 1.563– 42.558; P 3 (OR, 16.174; 95% CI, 3.064– 85.375; P=0.001) were significantly associated with VF occurrence after adjusting for multiple variables.Conclusion: An ischaemic J wave is an independent risk factor for VF in STEMI patients. BrP, slur morphology, and > 3 leads with an ischaemic J wave could increase the incidence of VF.Keywords: STEMI, ischaemic J wave, classification, predictor, ventricular fibrillatio