Electrocardiographic signs of RVOT conduction delay, specifically SII > SIII, strongly predicted ventricular tachyarrhythmia in Brugada syndrome patients (AUC 0.84, sensitivity 80%, specificity 89%).
Cohort (n=147)
Do electrocardiographic RVOT conduction delay parameters predict the development of ventricular tachyarrhythmia in patients with Brugada syndrome?
Electrocardiographic signs of RVOT conduction delay, specifically prominent S in lead I, SII > SIII, and positive Tzou criteria, are effective independent predictors of ventricular tachyarrhythmia in Brugada syndrome.
Effect estimate: AUC 0.84
BACKGROUND: Brugada syndrome (BrS) is an autosomal dominant disease responsible for sudden cardiac death in young individuals without structural anomalies. The most critical part in the management of this channelopathy is identification of high-risk patients, especially asymptomatic subjects. Prior studies have shown that conduction delay in the right ventricular outflow tract (RVOT) is the main mechanism for developing ventricular tachyarrhythmia (VTA) in BrS patients. The aim of this study was to investigate the significance of electrocardiographic RVOT conduction delay parameters as predictors for development of VTA in patients with BrS. METHODS AND RESULTS: We retrospectively analyzed electrocardiograms obtained from 147 BrS patients (43 ± 15 years, 65% men) and assessed the following electrocardiographic parameters: (1) Tzou criteria (V1R > 0.15 mV, V6S > 0.15 mV, and V6S:R > 0.2), (2) prominent S wave in lead I, lead II, and lead III, (3) SII > SIII, and (4) prominent Q wave in lead III as possible predictors of VTA occurrences during follow-up. Prominent SI, SII, SIII, SII > SIII, QIII, and +ve Tzou criteria occurred more frequently in patients who either presented with VTA or developed VTA during the follow-up of 56 (IQR: 40-76) months. SII > SIII has the highest area under the curve for prediction of VTA (AUC: 0.84, sensitivity: 80%, specificity: 89%). Multivariable regression analysis showed that prominent S waves in lead I, SII > SIII and +ve Tzou criteria are independent predictors for VTA in BrS patients. CONCLUSION: Prominent S in lead I, SII > SIII and +ve Tzou criteria can be used as effective signs for predicting VTA in patients with BrS.
Ragab et al. (Mon,) conducted a cohort in Brugada syndrome (n=147). Electrocardiographic RVOT conduction delay parameters was evaluated on Development of ventricular tachyarrhythmia (VTA) (AUC 0.84). Electrocardiographic signs of RVOT conduction delay, specifically SII > SIII, strongly predicted ventricular tachyarrhythmia in Brugada syndrome patients (AUC 0.84, sensitivity 80%, specificity 89%).