Early Repolarization: How to Differentiate the “Malignant” from the “Benign” Pattern

The early repolarization syndrome (ERS) on the electrocardiogram is characterized by J-point elevation, distinct J waves with or without ST-segment elevation, symmetric tall T wave, and slurring of the terminal part of the QRS in inferior limb and lateral precordial leads, but not in the V2 to V5 leads. The new definition of ERS proposed by Haissaguerre et al, centers more on the J wave notch or slur, irrespective of the ST-segment changes, which often helps to avoid overlap with the Brugada syndrome.