Key result
Automatic quantitative ECG measurements identified QRS prolongation in lead V1 >113ms (HR 3.49; 95% CI 1.72-7.09; P<0.001) and S duration on DI >33.5ms as independent predictors of major events.
Why the study?
Arrhythmic risk stratification is a major challenge in Brugada syndrome, where prior risk studies relied on manual electrocardiogram measurements.
Do automatic quantitative ECG measurements from digitized paper ECGs predict major arrhythmic events in patients with Brugada syndrome?
Cohort (n=301)
Yes
Do automatic quantitative ECG measurements from digitized paper ECGs predict major arrhythmic events in patients with Brugada syndrome?
Automatic quantitative ECG measurements from digitized paper ECGs, specifically QRS prolongation in V1 and S duration on DI, can independently predict major arrhythmic events in patients with Brugada syndrome.
Answers are grounded in this paper and cite their sources.
QRS >113 ms in V1 was associated with major events in Brugada syndrome; extends ECG predictors but leaves clinical adoption open pending validation.
BACKGROUND: Arrhythmic risk stratification is a major challenge in Brugada syndrome. Studies have evaluated risk stratification based on manually measured electrocardiogram (ECG) parameters at baseline and/or after drug challenge. AIM: To assess the predictive value of multiple ECG parameters measured automatically from digitized paper ECGs. METHODS: During a prospective, multicentre cohort study that included patients with Brugada syndrome with type 1 ECG (spontaneously or drug-induced), paper ECGs were digitized and analysed. Major events were sudden cardiac death, aborted cardiac arrest and appropriate implantable cardioverter-defibrillator (ICD) therapy in the ventricular fibrillation (VF) zone. The predictive value of clinical and ECG parameters was assessed using univariable and multivariable Cox models. RESULTS: ECGs from 301 patients (74% male, mean age 43.1±13.3years, mean follow-up 7.1±5.6years) were analysed. Major events occurred in 6% of patients before diagnosis and 8% during follow-up. Two baseline ECG parameters were independently associated with major events: QRS prolongation in lead V1>113ms (hazard ratio [HR] 3.49, 95% confidence interval [CI] 1.72-7.09; P<0.001) and S duration on DI>33.5ms (HR 3.56, 95% CI 1.52-8.31; P<0.01). In drug-induced patients, changes in the Tpeak-Tend interval on V2 were associated with major events (HR 4.69, 95% CI 1.21-18.17; P=0.014). CONCLUSION: Paper ECG datasets could be used for automatic quantitative ECG measurements. We confirmed the association of previously described parameters with events and identified useful new parameters. Multi-parametric ECG quantification may be used to assess risk in patients with Brugada syndrome.
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Laporte et al. (2024) conducted a cohort in Brugada syndrome (n=301). Automatized quantitative electrocardiography from digitized paper ECGs was evaluated on Major events (sudden cardiac death, aborted cardiac arrest and appropriate ICD therapy in the VF zone) (HR 3.49, 95% CI 1.72-7.09, p=<0.001). Automatic quantitative ECG measurements identified QRS prolongation in lead V1 >113ms (HR 3.49; 95% CI 1.72-7.09; P<0.001) and S duration on DI >33.5ms as independent predictors of major events.
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