Contemporary Perspectives on J-Wave Syndromes: An Expert Consensus Statement
Issued Date
2026-02-01
Resource Type
ISSN
18804276
eISSN
18832148
Scopus ID
2-s2.0-105030707008
Journal Title
Journal of Arrhythmia
Volume
42
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Arrhythmia Vol.42 No.1 (2026)
Suggested Citation
Nademanee K., Wilde A.A., Ackerman M.J., R. Behr E., Bezzina C.R., Chen P.S., Chung F.P., Coronel R., Haissaguerre M., Jiang C., Juang J.M.J., Khongphatthanayothin A., Makita N., Morita H., Nakagawa H., Ngarmukos T., Nogami A., Pappone C., Priori S.G., Rosso R., Shimizu W., Veerakul G., Viskin S. Contemporary Perspectives on J-Wave Syndromes: An Expert Consensus Statement. Journal of Arrhythmia Vol.42 No.1 (2026). doi:10.1002/joa3.70284 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/115444
Title
Contemporary Perspectives on J-Wave Syndromes: An Expert Consensus Statement
Author's Affiliation
Mayo Clinic
Universiteit van Amsterdam
Tel Aviv University
Cleveland Clinic Foundation
Amsterdam UMC - University of Amsterdam
Università degli Studi di Pavia
Zhejiang University School of Medicine
National Yang-Ming University Taiwan
National Taiwan University Hospital
Cedars-Sinai Medical Center
Taipei Veterans General Hospital
National Taiwan University College of Medicine
Università Vita-Salute San Raffaele
National Cerebral and Cardiovascular Center
Istituti Clinici Scientifici Maugeri Spa – SB
Gruppo Ospedaliero San Donato
Hopital Haut-Lévêque C.H.U de Bordeaux
St George's University Hospitals NHS Foundation Trust
Faculty of Medicine, University of Tsukuba
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Faculty of Medicine, Chulalongkorn University
Amsterdam Cardiovascular Sciences
Faculty of Medicine
Institut de Rythmologie et Modélisation Cardiaque
New Tokyo Hospital
City St George's, University of London
Bumrungrad International Hospital
Sapporo Teishinkai Hospital
Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province
Bangkok Heart Hospital
Pacific Rim Electrophysiology Research Institute
Universiteit van Amsterdam
Tel Aviv University
Cleveland Clinic Foundation
Amsterdam UMC - University of Amsterdam
Università degli Studi di Pavia
Zhejiang University School of Medicine
National Yang-Ming University Taiwan
National Taiwan University Hospital
Cedars-Sinai Medical Center
Taipei Veterans General Hospital
National Taiwan University College of Medicine
Università Vita-Salute San Raffaele
National Cerebral and Cardiovascular Center
Istituti Clinici Scientifici Maugeri Spa – SB
Gruppo Ospedaliero San Donato
Hopital Haut-Lévêque C.H.U de Bordeaux
St George's University Hospitals NHS Foundation Trust
Faculty of Medicine, University of Tsukuba
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Faculty of Medicine, Chulalongkorn University
Amsterdam Cardiovascular Sciences
Faculty of Medicine
Institut de Rythmologie et Modélisation Cardiaque
New Tokyo Hospital
City St George's, University of London
Bumrungrad International Hospital
Sapporo Teishinkai Hospital
Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province
Bangkok Heart Hospital
Pacific Rim Electrophysiology Research Institute
Corresponding Author(s)
Other Contributor(s)
Abstract
J-wave syndromes (JWS)—comprising Brugada syndrome (BrS) and early repolarization syndrome (ERS)—are important causes of malignant ventricular arrhythmias and sudden cardiac death in patients whose hearts appear structurally normal. Since the 2016 consensus, advances in genetics, pathophysiology, and therapy have redefined both understanding and management. BrS, once viewed as a purely electrical disorder, is now recognized along a microstructural–electrical continuum, with sodium-channel dysfunction and subtle epicardial fibrosis of the right ventricular outflow tract as key contributors. Likewise, ERS—historically considered benign—carries significant risk when inferolateral J-waves coexist with arrhythmic events. Genetically, SCN5A remains the sole gene with definitive disease association, while polygenic susceptibility materially modulates risk, underscoring complex inheritance. Risk stratification remains challenging: patients with prior cardiac arrest or arrhythmic syncope are highest risk, whereas asymptomatic individuals warrant multiparametric assessment integrating clinical features, ECG markers, electrophysiologic studies, and genetics. For decades, treatment centered on implantable cardioverter-defibrillators and quinidine, both limited by availability, tolerance, and device complications. More recently, epicardial substrate ablation has emerged as a transformative therapy, with large registries and randomized trials demonstrating durable suppression of ventricular fibrillation and acceptable safety. This APHRS-organized international consensus updates and extends the 2016 Expert Consensus and the 2022 ESC Guidelines, providing contemporary diagnostic frameworks, pragmatic risk-stratification tools, and treatment algorithms for BrS and ERS. It emphasizes JWS as a microstructural–electrical disease spectrum and elevates substrate ablation as a major therapeutic advance, while outlining priorities for genetics, risk-stratification and treatment algorithms.