Relationship Between an Ischaemic J Wave Pattern and Ventricular Fibrillation in ST-Elevation Myocardial Infarction Patients

BACKGROUND: This study determined the ischaemic J wave pattern associated with ventricular fibrillation (VF). METHODS: A total of 262 patients diagnosed with ST-elevation myocardial infarction (STEMI) were recruited from October 2017 to September 2020. All data were collected and analysed, including baseline characteristics, electrocardiogram (ECG), coronary angiography (CAG), and examination outcomes. RESULTS: There were 193 STEMI patients with J wave elevation but without an ischaemic J wave (NJ group) and 69 patients with an ischaemic J wave; the latter were then subgrouped into early repolarization pattern (ERP; n=62) and Brugada pattern groups (BrP [anteroseptal ERP]; n=7). Univariate and multivariate logistic regression analyses were used to clarify high-risk factors and characteristics of ischaemic J waves. Multivariate logistic regression analysis revealed that an ischaemic J wave (odds ratio [OR], 9.708; 95% CI, 2.570–36.664; P=0.01) independently predicted VF. In the subgroup analysis, BrP (OR, 31.214; 95% CI, 3.949–246.742; P=0.001), slur morphology of the ERP (OR, 8.15; 95% CI, 1.563–42.558; P<0.05), and the number of leads with an ischaemic J wave > 3 (OR, 16.174; 95% CI, 3.064–85.375; P=0.001) were significantly associated with VF occurrence after adjusting for multiple variables. CONCLUSION: An ischaemic J wave is an independent risk factor for VF in STEMI patients. BrP, slur morphology, and > 3 leads with an ischaemic J wave could increase the incidence of VF.