J wave

J wave is a pattern seen on an ECG that is associated with a higher risk of life-threatening arrhythmias. It is also known as Osborn wave and is often seen in patients with hypothermia or hypercalcemia.

Definition

The J wave is a deflection immediately following the QRS complex of the ECG. It is usually seen in the inferior or lateral leads and is often best seen in lead III. The J wave is thought to be due to a transient outward current in the ventricular epicardium, but not the endocardium, leading to a transmural voltage gradient during early repolarization.

Clinical significance

The presence of J waves is associated with a higher risk of life-threatening arrhythmias, particularly in the setting of hypothermia or hypercalcemia. However, the exact mechanism by which J waves contribute to arrhythmogenesis is not fully understood. Some studies suggest that the J wave may be a marker of underlying myocardial ischemia or infarction, while others suggest it may be a marker of early repolarization syndrome.

Treatment

The treatment of J waves is largely supportive and depends on the underlying cause. In the setting of hypothermia, rewarming is the mainstay of treatment. In the setting of hypercalcemia, treatment is aimed at lowering the serum calcium level. In some cases, antiarrhythmic drugs may be used to suppress the J wave and reduce the risk of arrhythmias.

See also

• Electrocardiogram
• Arrhythmia
• Hypothermia
• Hypercalcemia

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