Automated Electrocardiogram Analysis Identifies Novel Predictors of Ventricular Arrhythmias in Brugada Syndrome
Background: Patients suffering from Brugada syndrome (BrS) are at an increased risk of life-threatening ventricular arrhythmias. Whilst electrocardiographic (ECG) variables have been used for risk stratification with varying degrees of success, automated measurements have not been tested for their a...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2020.618254/full |
| _version_ | 1819054259764723712 |
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| author | Gary Tse Sharen Lee Andrew Li Dong Chang Guangping Li Jiandong Zhou Tong Liu Qingpeng Zhang |
| author_facet | Gary Tse Sharen Lee Andrew Li Dong Chang Guangping Li Jiandong Zhou Tong Liu Qingpeng Zhang |
| author_sort | Gary Tse |
| collection | DOAJ |
| description | Background: Patients suffering from Brugada syndrome (BrS) are at an increased risk of life-threatening ventricular arrhythmias. Whilst electrocardiographic (ECG) variables have been used for risk stratification with varying degrees of success, automated measurements have not been tested for their ability to predict adverse outcomes in BrS.Methods: BrS patients presenting in a single tertiary center between 2000 and 2018 were analyzed retrospectively. ECG variables on vector magnitude, axis, amplitude and duration from all 12 leads were determined. The primary endpoint was spontaneous ventricular tachycardia/ventricular fibrillation (VT/VF) on follow-up.Results: This study included 83 patients [93% male, median presenting age: 56 (41–66) years old, 45% type 1 pattern] with 12 developing the primary endpoint (median follow-up: 75 (Q1–Q3: 26–114 months). Cox regression showed that QRS frontal axis > 70.0 degrees, QRS horizontal axis > 57.5 degrees, R-wave amplitude (lead I) <0.67 mV, R-wave duration (lead III) > 50.0 ms, S-wave amplitude (lead I) < −0.144 mV, S-wave duration (lead aVL) > 35.5 ms, QRS duration (lead V3) > 96.5 ms, QRS area in lead I < 0.75 Ashman units, ST slope (lead I) > 31.5 deg, T-wave area (lead V1) < −3.05 Ashman units and PR interval (lead V2) > 157 ms were significant predictors. A weighted score based on dichotomized values provided good predictive performance (hazard ratio: 1.59, 95% confidence interval: 1.27–2.00, P-value<0.0001, area under the curve: 0.84).Conclusions: Automated ECG analysis revealed novel risk markers in BrS. These markers should be validated in larger prospective studies. |
| first_indexed | 2024-12-21T12:48:47Z |
| format | Article |
| id | doaj.art-894df34103b44be78469f890ca821b73 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-21T12:48:47Z |
| publishDate | 2021-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-894df34103b44be78469f890ca821b732022-12-21T19:03:33ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-01-01710.3389/fcvm.2020.618254618254Automated Electrocardiogram Analysis Identifies Novel Predictors of Ventricular Arrhythmias in Brugada SyndromeGary Tse0Sharen Lee1Andrew Li2Dong Chang3Guangping Li4Jiandong Zhou5Tong Liu6Qingpeng Zhang7Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, ChinaLaboratory of Cardiovascular Physiology, Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, ChinaFaculty of Science, University of Calgary, Calgary, AB, CanadaXiamen Cardiovascular Hospital, Xiamen University, Xiamen, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, ChinaSchool of Data Science, City University of Hong Kong, Hong Kong, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, ChinaSchool of Data Science, City University of Hong Kong, Hong Kong, ChinaBackground: Patients suffering from Brugada syndrome (BrS) are at an increased risk of life-threatening ventricular arrhythmias. Whilst electrocardiographic (ECG) variables have been used for risk stratification with varying degrees of success, automated measurements have not been tested for their ability to predict adverse outcomes in BrS.Methods: BrS patients presenting in a single tertiary center between 2000 and 2018 were analyzed retrospectively. ECG variables on vector magnitude, axis, amplitude and duration from all 12 leads were determined. The primary endpoint was spontaneous ventricular tachycardia/ventricular fibrillation (VT/VF) on follow-up.Results: This study included 83 patients [93% male, median presenting age: 56 (41–66) years old, 45% type 1 pattern] with 12 developing the primary endpoint (median follow-up: 75 (Q1–Q3: 26–114 months). Cox regression showed that QRS frontal axis > 70.0 degrees, QRS horizontal axis > 57.5 degrees, R-wave amplitude (lead I) <0.67 mV, R-wave duration (lead III) > 50.0 ms, S-wave amplitude (lead I) < −0.144 mV, S-wave duration (lead aVL) > 35.5 ms, QRS duration (lead V3) > 96.5 ms, QRS area in lead I < 0.75 Ashman units, ST slope (lead I) > 31.5 deg, T-wave area (lead V1) < −3.05 Ashman units and PR interval (lead V2) > 157 ms were significant predictors. A weighted score based on dichotomized values provided good predictive performance (hazard ratio: 1.59, 95% confidence interval: 1.27–2.00, P-value<0.0001, area under the curve: 0.84).Conclusions: Automated ECG analysis revealed novel risk markers in BrS. These markers should be validated in larger prospective studies.https://www.frontiersin.org/articles/10.3389/fcvm.2020.618254/fullBrugada syndromeautomated ECGrisk stratificationdepolarizationrepolarization |
| spellingShingle | Gary Tse Sharen Lee Andrew Li Dong Chang Guangping Li Jiandong Zhou Tong Liu Qingpeng Zhang Automated Electrocardiogram Analysis Identifies Novel Predictors of Ventricular Arrhythmias in Brugada Syndrome Frontiers in Cardiovascular Medicine Brugada syndrome automated ECG risk stratification depolarization repolarization |
| title | Automated Electrocardiogram Analysis Identifies Novel Predictors of Ventricular Arrhythmias in Brugada Syndrome |
| title_full | Automated Electrocardiogram Analysis Identifies Novel Predictors of Ventricular Arrhythmias in Brugada Syndrome |
| title_fullStr | Automated Electrocardiogram Analysis Identifies Novel Predictors of Ventricular Arrhythmias in Brugada Syndrome |
| title_full_unstemmed | Automated Electrocardiogram Analysis Identifies Novel Predictors of Ventricular Arrhythmias in Brugada Syndrome |
| title_short | Automated Electrocardiogram Analysis Identifies Novel Predictors of Ventricular Arrhythmias in Brugada Syndrome |
| title_sort | automated electrocardiogram analysis identifies novel predictors of ventricular arrhythmias in brugada syndrome |
| topic | Brugada syndrome automated ECG risk stratification depolarization repolarization |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2020.618254/full |
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