{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:20:49Z","timestamp":1791249649575,"version":"4.1.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,8,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Early repolarization pattern (ERP) is considered a common training\u2010related and benign ECG finding in young adult athletes. Few data exist on ERP in the pediatric athletes population. Therefore, we aimed to evaluate the ERP prevalence, characteristics, and prognosis in pediatric athletes aged \u226416 years.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Eight\u2010hundred eighty\u2010six consecutive pediatric athletes engaged in 17 different sports (mean age, 11.7\u00b12.5\u00a0years; 7\u201316 years) were enrolled and prospectively evaluated with medical history, physical examination, resting and exercise ECGs, and transthoracic echocardiography during their preparticipation screening. Known cardiovascular diseases associated with sudden cardiac death was considered exclusion criteria. Athletes were followed up yearly for 4\u00a0years. The prevalence of ERP was 117 (13.2%), equally distributed in both sexes (\n              <jats:italic>P<\/jats:italic>\n              =0.072), irrespectively of body mass index and classification of sports. The most common ERP localizations were inferolateral and inferior leads (53.8% and 27.3%, respectively). Notching J\u2010point morphology was the most prevalent (70%), and rapidly ascending ST elevation (96%) was the most common ST\u2010segment morphology. Athletes with ERP were older (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) had lower rest and recovery heart rates (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), increased precordial and limb R\u2010wave voltages (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), increased R\/S Sokolow index (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and longer PR interval (\n              <jats:italic>P<\/jats:italic>\n              =0.006) in comparison with the athletes without ERP. Neither major cardiovascular nor arrhythmic events, nor sudden cardiac death were recorded over a median follow\u2010up of 4.2\u00a0years. One hundred seventeen (80.3%) athletes with ERP exhibited a persistent ERP. ERP localization and J\u2010point morphology changed during follow\u2010up in 11 (11.7%) and 17 (18%) of athletes, respectively.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">ERP is common in pediatric athletes. It was mostly located in the inferolateral leads and associated with concave ascending ST segment with other training\u2010related ECG changes. The lack of either sudden cardiac death or cardiomyopathies linked to sudden cardiac death over follow\u2010up suggests that in pediatric athletes, ERP may be considered a benign training\u2010related ECG phenomenon with a potential dynamic pattern.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.020776","type":"journal-article","created":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T09:22:00Z","timestamp":1628846520000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Early Repolarization in Pediatric Athletes: A Dynamic Electrocardiographic Pattern With Benign Prognosis"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7220-123X","authenticated-orcid":false,"given":"Geza","family":"Halasz","sequence":"first","affiliation":[{"name":"Cardiology Department Guglielmo Da Saliceto Hospital Piacenza Italy"},{"name":"Cardiology Department Cardiocentro Ticino Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Cattaneo","sequence":"additional","affiliation":[{"name":"Cardiology Department Cardiocentro Ticino Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Piepoli","sequence":"additional","affiliation":[{"name":"Cardiology Department Guglielmo Da Saliceto Hospital Piacenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8792-3523","authenticated-orcid":false,"given":"Andrea","family":"Biagi","sequence":"additional","affiliation":[{"name":"Cardiology Department Guglielmo Da Saliceto Hospital Piacenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvio","family":"Romano","sequence":"additional","affiliation":[{"name":"Cardiology Department of Life Health &amp; Environmental Sciences University of L'Aquila L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Biasini","sequence":"additional","affiliation":[{"name":"Italian Sport Medicine Federation Clinic L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Villa","sequence":"additional","affiliation":[{"name":"Cardiovascular Intensive Care Unit Cardiocentro Ticino Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziano","family":"Cassina","sequence":"additional","affiliation":[{"name":"Cardiovascular Intensive Care Unit Cardiocentro Ticino Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Capelli","sequence":"additional","affiliation":[{"name":"Sport and Exercise Medicine Cardiocentro Ticino Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehp473"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.01.015"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.110.945824"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa071968"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000388"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.115.003577"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.014068"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1080\/AC.69.1.3011338"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.09.933"},{"key":"e_1_3_1_11_2","first-page":"9","article-title":"Classificazione degli sport in relazione all\u2019impegno cardiovascolare","volume":"63","author":"Faina MVA","year":"2010","unstructured":"Faina MVA, Biffi A. 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