High voltage J-waves as a predictor of death in acute ST-Segment elevated myocardial infarction in hospital

Aims: Stratification of the risk of malignant arrhythmias in patients with coronary artery disease remains a challenge. This study evaluated the potential of high voltage J-waves in patients with acute ST-segment elevated myocardial infarction (STEMI) to predict the risk of malignant arrhythmias during hospitalization. Methods: A total of 128 consecutive STEMI patients with J-waves were enrolled within 48 h after the onset of the STEMI in this prospective study. The mean age was 62.97 ± 12.1 years, and 108 patients were male. Both 12-lead electrocardiograms (ECGs) and right-sided chest lead ECGs were recorded simultaneously within 10 min of admission to the hospital. Continuous ECG monitoring was administered from admission until discharge. Clinical characteristics and ECG parameters were compared between patients who survived and those who died during hospitalization. Results: Malignant ventricular arrhythmias (MVAs) were seen with J-waves more frequently in STEMI patients who subsequently died (P < 0.05). J-wave voltage, QTDc, Tp-e, and the Tp-e/QT ratio increased significantly in patients who died (P < 0.05). Multivariate logistic regression analysis revealed that J-wave voltage (odds ratio [OR], 89.09; 95% confidence interval [CI], 2.606-3045.108; P < 0.05) and MVAs (OR, 4.296; 95% CI, 1.348–13.693; P < 0.05) were associated with the occurrence of sudden death in patients with STEMI during hospitalization. Conclusions: High voltage J-waves are a potential ECG parameter for predicting sudden death in patients with STEMI during hospitalization.