Automatized quantitative electrocardiography from digitized paper electrocardiograms: A new avenue for risk stratification in patients with Brugada syndrome - 23/01/25
, Martino Vaglio b, Isabelle Denjoy a, Pierre Maison-Blanche a, Charlène Coquard a, Nathan El Bèze c, Philippe Maury d, Alexis Hermida e, Didier Klug f, Alice Maltret g, Fabio Badilini b, Antoine Leenhardt a, Fabrice Extramiana a, ⁎
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Graphical abstract |
Highlights |
• | We digitized the electrocardiograms (ECGs) of patients with Brugada syndrome. |
• | We performed multi-parametric ECG quantification to assess risk in such patients. |
• | We identified new ECG parameters independently associated with major events. |
Abstract |
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.
Le texte complet de cet article est disponible en PDF.Keywords : Brugada syndrome, ECG digitalization, Automatic measurement, Arrhythmic risk stratification, Multi-parametric ECG quantification
Plan
Vol 118 - N° 1
P. 17-25 - janvier 2025 Retour au numéro
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