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Automatized quantitative electrocardiography from digitized paper electrocardiograms: A new avenue for risk stratification in patients with Brugada syndrome
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Edité par CCSD ; Elsevier ; Société française de cardiologie [2008-....] -
International audience. 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 ± 13.3 years, mean follow-up 7.1 ± 5.6 years) 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 > 113 ms (hazard ratio [HR] 3.49, 95% confidence interval [CI] 1.72–7.09; P < 0.001) and S duration on DI > 33.5 ms (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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