Automated Electrocardiogram Analysis Identifies Novel Predictors of Ventricular Arrhythmias in Brugada Syndrome

Gary Tse*, Sharen Lee, Andrew Li, Dong Chang, Guangping Li, Jiandong Zhou, Tong Liu*, Qingpeng Zhang*

*Corresponding author for this work

Research output: Journal Publications and ReviewsRGC 21 - Publication in refereed journalpeer-review

17 Citations (Scopus)
63 Downloads (CityUHK Scholars)

Abstract

Background: Patients suffering from Brugada syndrome (BrS) are at an increased riskof life-threatening ventricular arrhythmias. Whilst electrocardiographic (ECG) variableshave been used for risk stratification with varying degrees of success, automatedmeasurements 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 2018were analyzed retrospectively. ECG variables on vector magnitude, axis, amplitude andduration from all 12 leads were determined. The primary endpoint was spontaneousventricular 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 (medianfollow-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-waveduration (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) < −3.05Ashman units and PR interval (lead V2) > 157 ms were significant predictors. A weightedscore 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. Thesemarkers should be validated in larger prospective studies.
Original languageEnglish
JournalFrontiers in Cardiovascular Medicine
Volume7
Online published14 Jan 2021
DOIs
Publication statusPublished - Jan 2021

Publisher's Copyright Statement

  • This full text is made available under CC-BY 4.0. https://creativecommons.org/licenses/by/4.0/

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