J Korean Med Sci.  2014 May;29(5):685-690. 10.3346/jkms.2014.29.5.685.

The Relationship Between J Wave on the Surface Electrocardiography and Ventricular Fibrillation during Acute Myocardial Infarction

• Kim SH
• Kim DH
• Park SD
• Baek YS
• Woo SI
• Shin SH
• Kwan J
• Park KS

• KMID: 1786111
• DOI: http://doi.org/10.3346/jkms.2014.29.5.685

Abstract

We investigated whether the presence of J wave on the surface electrocardiography (sECG) could be a potential risk factor for ventricular fibrillation (VF) during acute myocardial infarction (AMI). We performed a retrospective study of 317 patients diagnosed with AMI in a single center from 2009 to 2012. Among the enrolled 296 patients, 22 (13.5%) patients were selected as a VF group. The J wave on the sECG was defined as a J point elevation manifested through QRS notching or slurring at least 1 mm above the baseline in at least two leads. We found that the incidence of J wave on the sECG was significantly higher in the VF group. We also confirmed that several conventional risk factors of VF were significantly related to VF during AMI; time delays from the onset of chest pain, blood concentrations of creatine phosphokinase and incidence of ST-segment elevation. Multiple logistic regression analysis demonstrated that the presence of J wave and the presence of a ST-segment elevation were independent predictors of VF during AMI. This study demonstrated that the presence of J wave on the sECG is significantly related to VF during AMI.

Keyword

J Wave; Ventricular Fibrillation; Acute Myocardial Infarction

MeSH Terms

Arrhythmias, Cardiac/*diagnosis
Creatine Kinase/blood
*Electrocardiography
Female
Heart Conduction System/*abnormalities
Humans
Male
Middle Aged
Myocardial Infarction/*diagnosis/pathology
Retrospective Studies
Risk Factors
Ventricular Fibrillation/*diagnosis/pathology/physiopathology
Creatine Kinase

Figure

• 

  Fig. 1 Baseline ECGs in AMI patients. (A) and (B) show notched elevations (arrows) in inferior (A) and lateral (B) leads in the patients who had an event of VF, whereas (C) and (D). show no J wave in inferior (C) or lateral (D) leads in the patients who showed no VF during AMI.

• 

  Fig. 2 Relationship between notched J wave and VF.The incidence of J wave is significantly higher in the VF group.

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