Clinical significance of J wave in prediction of ventricular arrhythmia in patients with acute myocardial infarction

Cheng I. Wu, Shih Lin Chang*, Chin Yu Lin, Jennifer Jeanne B. Vicera, Yenn Jiang Lin, Li Wei Lo, Fa Po Chung, Yu Feng Hu, Ting Yung Chang, Tze Fan Chao, Jo Nan Liao, Ta Chuan Tuan, Chih Min Liu, Abigail Louise D. Te, Shih Ann Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: J wave syndrome and myocardial ischemia are related with malignant ventricular arrhythmia (VA). The characteristics of dynamic J wave in patients with early phase of acute myocardial infarction (AMI) and subsequent VA or electrical storm (ES) have not been well evaluated. Objective: We investigated the utility of J wave in the prediction of VA and ES in patients within the early phase of AMI. Methods: This study retrospectively enrolled 208 patients (mean age 69 ± 15 years, 171 males) with AMI. Of them, 50 patients had experienced VA during hospitalization and 24 had ES. The clinical and electrocardiographic characteristics of these patients with and without VA were compared. Results: Patients with VA had a higher incidence of chronic kidney disease (CKD) and J wave compared with those without VA. The hazard ratio (HR) of J wave for VA was 4.31 (p < 0.01) and CKD was 2.64 (p < 0.01). In the VA group, ES patients had a higher incidence of diabetes mellitus (DM) (HR 2.73, p = 0.02) and J wave (HR 4.21, p < 0.01). If the AMI patients had J wave, the OR for mortality was 2.14 (p = 0.03), VA events was 6.23 (p < 0.01), and ES events was 12.15 (p < 0.01). If VA patients had J wave, the mortality rate will significantly increase (OR 68.62, p = 0.01). Conclusion: The AMI patients who develop VA in the early phase of AMI had a higher incidence of J wave and CKD, and those who develop ES had a higher incidence of J wave and DM. It seems that J wave in AMI patients is a poor prognostic factor, and we found that J wave will increase mortality, VA events, and ES events. The majority locations of J wave were inferior leads although there was no relationship between the locations and VA incidence. If the VA patients had inferior or lateral J wave, it would further increase the risk of mortality.

Original languageEnglish
Pages (from-to)351-357
Number of pages7
JournalJournal of Cardiology
Issue number5
StatePublished - May 2019


  • Electric storm
  • J wave
  • Ventricular arrhythmia


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