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The Year of 2011 in Electrocardiology

Undoubtedly, last year the subject of ER raised the most vivid discussion among electrocardiographists and electrophysiologists. Based on a follow-up of about 10 years of over 15,000 middleaged subjects, Olson et al.1 demonstrated that the characteristic ST-elevation at the J-point was associated with an increased sudden cardiac death (SCD) in whites and in females, but not in blacks or males. Japanese investigators2 reviewed the ECG records of nearly 6000 atomic bomb survivors who were examined at least once during biannual health examinations in Nagasaki between 1958 and 2004; ER pattern had an elevated risk of unexpected death and a decreased risk of cardiac and all-cause death, although the hazard ratio for unexpected death in ER pattern was lower than that in patients with Brugada (Br)-type ECG. The characteristics of the ECG manifestations of ER in a general population was scrutinized by Tikkanen et al.;3 subjects with ER ≥ 0.1 mV and horizontal/descending ST-variant had an increased hazard ratio of arrhythmic death; an even higher hazard ratio of arrhythmic death was observed with higher amplitude ER in inferior leads and horizontal/descending ST-segment variant. In subjects with ascending ST, the relative risk for arrhythmic deaths was not increased. The heritability basis of ER pattern in the general population was stressed by Noseworthy et al.,4 al-