Stoller M, et al. - Researchers examined how myocardial ischemia influences early repolarization (ER). Procedural ECGs of patients with ER undergoing a controlled, 1-minute coronary occlusion for collateral function testing were retrospectively analyzed. Analysis of ECG leads with ER was done before, at 60 seconds of coronary balloon occlusion and > 30 seconds after balloon deflation. One hundred and thirty-five coronary balloon occlusions were undertaken in 77 patients with ER in the preprocedural ECG (86% inferior, 20% lateral) during which a J wave was recorded in 224 leads (ER leads). As per observations, J-wave amplitude mirrors ST-segment changes during acute ischemia. The increased arrhythmic vulnerability of patients with ER during myocardial ischemia could be explained with this observation. Further, this observation adds weight to the hypothesis of ER being a phenomenon of repolarization.