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Background <p>Early 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.</p> Methods <p>We 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).</p> Results <p>From 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, <i>p</i> &lt; 0.00001; OR = 4.26, 95% CI = 2.60–6.99, <i>p</i> &lt; 0.00001; respectively). Similarly, an ERP amplitude &gt; 0.2 mV was associated with a higher risk of SCD, along with horizontal elevation, slurred, and notched morphology (<i>p</i> &lt; 0.05). However, there is no predictive value on lateral lead distribution and ascending morphology. All studies were considered good quality by NOS.</p> Conclusion <p>This 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.</p>

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Electrocardiographic predictor of sudden cardiac death in patient with early repolarization pattern: a systematic review & meta-analysis

  • 期刊论文

  • 发表日期：

    2026年3月23日

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  • Jonathan Vincent Lee,
  • Mirela Emmanuela,
  • Andrew Patricio,
  • Dimetrio Alonzo Theja,
  • Jonathan Bryan Lee,
  • Nicholas Adrian Fahendra,
  • Nicolaus Novian Dwiya Wahjoepramono,
  • Hendyono Lim

摘要

Background

Early 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.

Methods

We 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).

Results

From 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.

Conclusion

This 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.