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From American Heart Association

www.circ.ahajournals.org/cgi/content/full/98/18/1937

The J point in the ECG is the point where the QRS complex joins the ST segment. It represents the approximate end of depolarization and the beginning of repolarization as determined by the surface ECG. There is an overlap of 10 milliseconds. The J point may deviate from the baseline in early repolarization, epicardial or endocardial ischemia or injury, pericarditis, right or left bundle-branch block, right or left ventricular hypertrophy, or digitalis effect. The term J deflection has been used to designate the formation of the wave produced when there is a large, prominent deviation of the J point from the baseline. The J deflection has been called many names, including camel-hump sign, late delta wave, J-point wave, and Osborn wave.

The prominent J deflection attributed to hypothermia was first reported in 1938 by Tomaszewski. The wave was observed by others, including Kossmann,Grosse-Brockhoff and Schoedel, Bigelow et al, Juvenelle et al, and Osborn.

Over the years, the unusual wave increasingly has been called an Osborn wave (Figure 4B ), probably because of Osborn's excellent article written in 1953. Clinicians labeled the deflection an Osborn wave in honor of Osborn, one of the first American Heart Association research fellows.

Much has been written about the abnormal J deflection observed in patients with hypercalcemia. Other conditions have been reported to cause an abnormal J deflection, including brain injury, subarachnoid hemorrhage, damage to sympathetic nerves in the neck, and cardiopulmonary arrest from oversedation. Brugada and Brugada reported patients with right bundle-branch block who exhibited noncoronary ST-segment elevation in the right precordial leads and experienced ventricular tachycardia or ventricular fibrillation. A controversy now surrounds this condition because not all of the tracings show classic right bundle-branch block, and some patients might have arrhythmogenic right ventricular dysplasia.

All J-wave deflections do not look alike. Some are merely elevations of ST segments in leads V1 and V2, whereas others are of the spike-and-dome variety. This leads to the conclusion that different mechanisms may be responsible for the size and shape of J-wave deflections.

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Q: What is J point in ECG?
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