Possibly yes !
In a preliminary analysis of 50 consecutive ECGs with ERS pattern, only 3 were females .An astonishingly low incidence of 6 % is it not ? . The 94 % exclusivity in males demands a detailed EP analysis of this entity.
How often you see an ECG such as this one in young women ?
This finding may not be a surprise , if we link another fact namely , the longevity of QT interval in women. Repolarisation begins when rapid sodium channel extinguishes and potassium channel starts firing and efflux this cation from within the cell .This happens during interface between phase 0 and phase 1. This point corresponds to the onset of repolarisation.
The onset of repolarisation is not entirely related to K+ efflux (Rather K + determines largely the duration of repolarisation).QT interval is prolonged in females because repolarisation is slow in women .In men it is early , short and swift .
The mysteries surrounding the ion channels especially the K+ with vast genetic and gender heterogeneity is yet be unraveled. Influence of sex hormones on right from the early days of fetus could be one such area for research.
Other related gender specific ECG findings include
- In women T waves rarely grow beyond 5 mm. In young men tall T waves are the rule
- An iso- electric or even inverted T waves especially in leads V 1 to V4 are quiet a common finding in women.
Link to another article on Early repolarisation syndrome from this blog
Final message
It is a well recognised fact , repolarisation is brisk in men and slow in women .It is now realised , the onset of repolarisation is also earlier in most men . This has a direct bearing in the impact of ischemia on fibrillation threshold . Arrhythmias induced by EADs are logically more common in persons with ERS.
Statistics again reveal men are more likely to have primary VF during STEMI . ( Male Gender by itself a CAD risk factor !) .Recently Hassagure et all elegantly documented , ERS is indeed a risk factor for primary VF at times of ischemia
Reference:
In the above article , the incidence of ERS was 72% in males , considerably lower than our observation . Still , the male dominance is confirmed. We still feel in our country true ERS occurs in a negligible minority of women. This finding need to be confirmed with data from other centers .
Dr.S.Venkatesan MD 