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Home / Benign early repolarisation, J point elevation Action Potential and Repolarization Action Potential Spreads in the myocardial wall from endocardium to epicardium The action potential curve has a different shape in the endocardium and epicardium Due to the different properties of ion channels Ventricular Depolarization (Phase 0) Creates the QRS complex on the ECG Ventricular Repolarization (Phase 1) Begins on the ECG as the ST segment Phase 1 is the beginning of repolarization Often referred to as early repolarization Benign Early Repolarization It is a benign ion channel disturbance in the epicardium occurring during early repolarization (Phase 1) On the ECG it appears as Concave ST elevation Higher ST segment elevation Notch (J wave) Prevalence is approximately 5% of the population Considered a variant of normal It is uncertain whether Benign Early Repolarization (BER) is a risk factor for ventricular fibrillation and sudden cardiac death Typically found in young people under 50 years old , especially: Athletes and African-Americans ECG and Benign Early Repolarization Elevation of the J-point in at least 2 adjacent leads Most commonly in precordial leads (V2-6) The J-point connects the QRS and ST segment J wave in precordial leads At the end of the QRS complex J wave Concave ST elevations over the entire heart, but mainly precordial (V2-V6) Most commonly up to 2mm in precordial leads , and up to 0.5mm in limb leads Size depends on heart rate Increases with bradycardia Disappears with tachycardia Tall, peaked T waves over the entire heart, but mainly precordial (V2-V6) ST/T ratio (V6) 0.25 No fish hook pattern (V4) Normal T wave amplitude ECG changes gradually resolve (approx

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