Intracardiac J-point elevation before the onset of polymorphic ventricular tachycardia and ventricular fibrillation in patients with an implantable cardioverter-defibrillator

Larisa G. Tereshchenko, Aaron McCabe, Lichy Han, Sanjoli Sur, Timothy Huang, Joseph Marine, Alan Cheng, David D Spragg, Sunil Sinha, Hugh Calkins, Kenneth Stein, Gordon F. Tomaselli, Ronald D Berger

Research output: Contribution to journalArticle


Background: The clinical importance of the J-point elevation on electrocardiogram is controversial. Objective: To study intracardiac J-point amplitude before ventricular arrhythmia. Methods: Baseline 12-lead electrocardiogram and far-field right ventricular intracardiac implantable cardioverter-defibrillator electrograms were recorded at rest in 494 patients (mean age 60.4 ± 13.1 years; 360 [72.9%] men) with structural heart disease (278 [56.3%] ischemic cardiomyopathy) who received primary (463 [93.9%] patients) or secondary prevention implantable cardioverter-defibrillator. Ten-second intracardiac far-field electrograms before the onset of arrhythmia were compared with the baseline. The J-point amplitude was measured on the baseline 12-lead surface electrocardiogram and the intracardiac far-field electrogram. The relative J-point amplitude was calculated as the ratio of J-point amplitude to peak-to-peak R-wave. Results: The paired t test showed that the relative intracardiac J-point amplitude was significantly higher before polymorphic ventricular tachycardia/ventricular fibrillation (VF) onset (0.28 ± 0.08 vs -0.19 ± 0.39; P =.012) than at baseline. In a mixed-effects logistic regression model, adjusted for multiple episodes per patient, each 10% increase in relative J-point amplitude increased the odds of having ventricular tachycardia/VF by 13% (odds ratio 1.13 [95% confidence interval 1.07-1.19]; P

Original languageEnglish (US)
Pages (from-to)1594-1602
Number of pages9
JournalHeart Rhythm
Issue number10
StatePublished - Oct 2012



  • Electrocardiography
  • Implantable cardioverter-defibrillator
  • Intracardiac electrogram
  • J-point elevation
  • Ventricular arrhythmia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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