{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T20:38:57Z","timestamp":1792269537304,"version":"4.4.0"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early repolarization syndrome (ERS) has typically been regarded as a benign electrocardiographic variant; however, recent studies have demonstrated its association with ventricular fibrillation (VF) and sudden cardiac death (SCD) in specific patients. Risk stratification poses significant challenges due to the high prevalence of early repolarization patterns in healthy individuals and the low incidence of malignant arrhythmias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>We report a case of a 30-year-old man with no significant medical history who presented with unexplained syncope and demonstrated J-wave abnormalities in the lateral leads. Since the patient did not meet guideline-based criteria for implantable cardioverter-defibrillator (ICD) implantation, he underwent management with an insertable cardiac monitor (ICM) for long-term rhythm surveillance. Six months later, the patient suffered SCD secondary to VF, which the ICM confirmed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This retrospective review revealed several subtle indicators of arrhythmic risk, including nocturnal J-wave augmentation and pilsicainide-induced J-point elevation. This case highlights the limitations of current ERS risk-stratification strategies and underscores the need to consider non-ICD preventive approaches, such as enhanced risk communication and strategic installation of an automated external defibrillator for patients who do not meet ICD therapy criteria but remain at potential arrhythmic risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag663","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:32:57Z","timestamp":1788521577000},"source":"Crossref","is-referenced-by-count":1,"title":["Sudden cardiac death in early repolarization syndrome despite detailed evaluation for syncope: a case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1265-736X","authenticated-orcid":false,"given":"Tsubasa","family":"Saeki","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hyogo Prefectural Awaji Medical Center , 1-1-137 Shioya, Sumoto City 656-0021 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8507-6949","authenticated-orcid":false,"given":"Soichiro","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hyogo Prefectural Awaji Medical Center , 1-1-137 Shioya, Sumoto City 656-0021 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7054-4692","authenticated-orcid":false,"given":"Masanori","family":"Okuda","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hyogo Prefectural Awaji Medical Center , 1-1-137 Shioya, Sumoto City 656-0021 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"2026091700520026500_ytag663-B1","doi-asserted-by":"crossref","first-page":"2016","DOI":"10.1056\/NEJMoa071968","article-title":"Sudden cardiac arrest associated with early repolarization","volume":"358","author":"Ha\u00efssaguerre","year":"2008","journal-title":"N Engl J Med"},{"key":"2026091700520026500_ytag663-B2","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1016\/j.jacc.2008.07.010","article-title":"J-point elevation in survivors of primary ventricular fibrillation and matched control subjects: incidence and clinical significance","volume":"52","author":"Rosso","year":"2008","journal-title":"J Am Coll Cardiol"},{"key":"2026091700520026500_ytag663-B3","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.jacc.2008.10.044","article-title":"Characteristics of recurrent ventricular fibrillation 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pattern and syncope","volume":"19","author":"Kamakura","year":"2022","journal-title":"Heart Rhythm"},{"key":"2026091700520026500_ytag663-B7","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1016\/j.jacc.2013.05.081","article-title":"Significance of non-type 1 anterior early repolarization in patients with inferolateral early repolarization syndrome","volume":"62","author":"Kamakura","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"2026091700520026500_ytag663-B8","doi-asserted-by":"crossref","first-page":"2514","DOI":"10.1161\/01.CIR.0000034169.45752.4A","article-title":"Proposed diagnostic criteria for the Brugada syndrome: consensus report","volume":"106","author":"Wilde","year":"2002","journal-title":"Circulation"},{"key":"2026091700520026500_ytag663-B9","doi-asserted-by":"crossref","first-page":"2261","DOI":"10.1016\/j.hrthm.2014.08.022","article-title":"Circadian pattern of fibrillatory events in non-Brugada-type idiopathic ventricular fibrillation with a focus on J waves","volume":"11","author":"Aizawa","year":"2014","journal-title":"Heart Rhythm"},{"key":"2026091700520026500_ytag663-B10","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1016\/j.hrthm.2018.10.040","article-title":"Depolarization versus repolarization abnormality underlying inferolateral J-wave syndromes: new concepts in sudden cardiac death with apparently normal hearts","volume":"16","author":"Ha\u00efssaguerre","year":"2019","journal-title":"Heart Rhythm"},{"key":"2026091700520026500_ytag663-B11","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1016\/j.hrthm.2024.04.101","article-title":"Risk stratification for the occurrence of ventricular fibrillation in patients with early repolarization syndrome","volume":"21","author":"Morita","year":"2024","journal-title":"Heart Rhythm"},{"key":"2026091700520026500_ytag663-B12","first-page":"603","article-title":"Presence and use of automated external defibrillators in occupational setting, 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