Evolution of Early Repolarization Patterns after 5 Years in a Military Population at Low Cardiovascular Risk and Practical Implications in Military Medical Expertise

Ann Noninvasive Electrocardiol. 2015 Sep;20(5):420-5. doi: 10.1111/anec.12231. Epub 2014 Nov 13.

Abstract

Background: The French military population is a young and athletic population with a high prevalence of early repolarization patterns (ERP) compared to the general population. Screening of military officers at risk of sudden death (SD) is a priority in military medical expertise. The aim of our study was to evaluate the prevalence of ERP and its evolution over a period of 5 years in a specific asymptomatic population, free of heart disease and cardiovascular risk factors.

Methods: From March to December 2008, we prospectively collected the electrocardiograms (ECGs) of military officers enlisted into the submarine forces of France. For 5 years (until 2012), the military officers included in the study underwent a clinical examination twice per year. A new ECG was carried out 5 years after the initial one.

Results: A total of 250 male subjects were included (mean age 22.87 ± 0.5 years). The prevalence of ERP was 19.2%. The most common appearance was an elevation of a slurring type J point (31/48 or 64.5%) in inferolateral leads (18/48 or 37.8%). After 5 years, the prevalence of ERP was identical to that of the previous period (19.2%) with no change in appearance, distribution, and amplitude in 47 subjects (97.9%). Repolarization changed in two patients (one occurrence of ERP and one disappearance). During the 5 years of follow-up, the subjects remained asymptomatic

Conclusion: ERP is common in our population of young, athletic, and asymptomatic military officers and changes little in 5 years.

Keywords: early repolarization; sudden death; young subjects.

MeSH terms

  • Arrhythmias, Cardiac / complications
  • Arrhythmias, Cardiac / diagnosis*
  • Arrhythmias, Cardiac / epidemiology
  • Brugada Syndrome
  • Cardiac Conduction System Disease
  • Cardiovascular Diseases / epidemiology
  • Death, Sudden, Cardiac / etiology
  • Death, Sudden, Cardiac / prevention & control
  • Electrocardiography
  • France / epidemiology
  • Heart Conduction System / abnormalities*
  • Humans
  • Male
  • Military Personnel*
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Submarine Medicine / standards
  • Young Adult