• J wave;
  • ischemia

We describe a case of a myocardial infarction, in which prominent ischemic J waves were documented during recurrent ventricular fibrillation attacks. The patient was referred to our hospital to treat an out-of hospital cardiac arrest. Although the 12-lead electrocardiogram obtained just after the first cardioversion did not show any apparent J waves, a J wave-like steep downsloping type ST-segment elevation associated with q waves in the inferior leads was documented during multiple episodes of ventricular fibrillation. Our report revealed the appearance of J waves as an important marker for lethal arrhythmias in acute ischemia. (PACE 2012; 35:e27–e30)