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Defining electrocardiographic criteria to differentiate non-type 1 Brugada ECG variants from normal incomplete RBBB patterns in the young SCD-SOS cohort.
Carrington, Mafalda; Creta, Antonio; Young, William J; Carrington, Maria; Henriques, Jorge; Teixeira, Rogério; Gonçalves, Lino; Lambiase, Pier D; Providência, Rui.
Afiliação
  • Carrington M; Cardiology Department, Hospital do Espírito Santo de Évora, Évora, Portugal.
  • Creta A; Cardiology Department, Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Young WJ; Cardiology Department, Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Carrington M; William Harvey Research Institute, Queen Mary University of London, London, UK.
  • Henriques J; IE Business School, Madrid, Spain.
  • Teixeira R; Department of Computer Science and Engineering, Centro de Informática e Sistemas, Universidade de Coimbra, Coimbra, Portugal.
  • Gonçalves L; Cardiology Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
  • Lambiase PD; Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal.
  • Providência R; Cardiology Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
J Cardiovasc Electrophysiol ; 33(9): 2083-2091, 2022 09.
Article em En | MEDLINE | ID: mdl-35771489
ABSTRACT

INTRODUCTION:

We assessed the prevalence of non-type 1 Brugada pattern (T1BrP) in children and young adults from the Sudden Cardiac Death-Screening Of risk factorS cohort and the diagnostic yield of nonexpert manual and automatic algorithm electrocardiogram (ECG) measurements.

METHODS:

Cross-sectional study. We reviewed 14 662 ECGs and identified 2226 with a rSr'-pattern in V1-V2. Among these, 115 were classified by experts in hereditary arrhythmic-syndromes as having or not non-T1BrP, and were compared with measurements of 5 ECG-derived parameters based on a triangle formed by r' -wave (d(A), d(B), d(B)/h, ß-angle) and ST-ascent, assessed both automatically and manually by nonexperts. We estimated intra- and interobserver concordance for each criterion, calculated diagnostic accuracy and defined the most appropriate cut-off values.

RESULTS:

A rSr'-pattern in V1-V2 was associated with higher PQ interval and QRS duration, male gender, and lower body mass index (BMI). The manual measurements of non-T1BrP criteria were moderately reproducible with high intraobserver and moderate interobserver concordance coefficients (ICC 0.72-0.98, and 0.63-0.76). Criteria with higher discriminatory capacity were distance d(B) (0.72; 95% confidence interval [CI] 0.65-0.80) and ST-ascent (0.87; 95% CI 0.82-0.92), which was superior to the 4 r'-wave criteria together (area under curve [AUC 0.74]). We suggest new cut-offs with improved combination of sensitivity and specificity d(B) ≥ 1.4 mm and ST-ascent ≥ 0.7 mm (sensitivity 1%-82%; specificity 71%-84%), that can be automatically measured to allow classification in four morphologies with increasing non-T1BrP probability.

CONCLUSION:

rSr'-pattern in precordial leads V1-V2 is a frequent finding and the detection of non-T1BrP by using the aforementioned five measurements is reproducible and accurate. In this study, we describe new cut-off values that may help untrained clinicians to identify young individuals who may require further work-up for a potential Brugada Syndrome diagnosis.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Eletrocardiografia / Síndrome de Brugada Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Child / Humans / Male Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Eletrocardiografia / Síndrome de Brugada Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Child / Humans / Male Idioma: En Ano de publicação: 2022 Tipo de documento: Article