A predictive model based on heart rate variability features during exercise testing and recovery distinguished symptomatic from asymptomatic Brugada syndrome patients with an AUC of 0.92.
Observational (n=105)
Yes
Does time-frequency heart rate variability (HRV) analysis during exercise testing accurately distinguish between symptomatic and asymptomatic patients with Brugada syndrome?
Heart rate variability analysis during exercise testing and recovery can accurately classify symptomatic versus asymptomatic patients with Brugada syndrome, offering a potential tool for risk stratification.
Ventricular arrhythmias in Brugada syndrome (BS) typically occur at rest and especially during sleep, suggesting that changes in the autonomic modulation may play an important role in arrhythmogenesis. The autonomic response to exercise and subsequent recovery was evaluated on 105 patients diagnosed with BS (twenty-four were symptomatic), by means of a time-frequency heart rate variability (HRV) analysis, so as to propose a novel predictive model capable of distinguishing symptomatic and asymptomatic BS populations. During incremental exercise, symptomatic patients showed higher HFnu values, probably related to an increased parasympathetic modulation, with respect to asymptomatic subjects. In addition, those extracted HRV features best distinguishing between populations were selected using a two-step feature selection approach, so as to build a linear discriminant analysis (LDA) classifier. The final features subset included one third of the total amount of extracted autonomic markers, mostly acquired during incremental exercise and active recovery, thus evidencing the relevance of these test segments in BS patients classification. The derived predictive model showed an improved performance with respect to previous works in the field (AUC = 0.92 ± 0.01; Se = 0.91 ± 0.06; Sp = 0.90 ± 0.05). Therefore, based on these findings, some of the analyzed HRV markers and the proposed model could be useful for risk stratification in Brugada syndrome.
Calvo et al. (Tue,) conducted a observational in Brugada syndrome (n=105). Exercise testing with heart rate variability (HRV) analysis vs. Asymptomatic Brugada syndrome patients was evaluated on Area under the ROC curve (AUC) of the predictive model. A predictive model based on heart rate variability features during exercise testing and recovery distinguished symptomatic from asymptomatic Brugada syndrome patients with an AUC of 0.92.
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