Presence of J-point elevation with rapidly ascending ST segment in the anterior leads of the 12-lead electrocardiogram has been generally considered a benign phenomenon. The concept of benign nature of J-waves has changed as data emerged on variants of J-waves that were associated with the increased risk of sudden cardiac death. Two specific inherited arrhythmia syndromes, such as Brugada syndrome and early repolarization syndrome, have been recognized that carry an increased risk for ventricular fibrillation. The current review is aimed at discussing the clinical aspects of these syndromes and the implications of incidental recognition of the J-waves in a randomly recorded electrocardiogram of asymptomatic subjects.
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