Article Dans Une Revue Archives of cardiovascular diseases Année : 2024

Automatized quantitative electrocardiography from digitized paper electrocardiograms: A new avenue for risk stratification in patients with Brugada syndrome

Résumé

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.

Dates et versions

hal-04753406 , version 1 (25-10-2024)

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Pierre-Léo Laporte, Martino Vaglio, Isabelle Denjoy, Pierre Maison-Blanche, Charlène Coquard, et al.. Automatized quantitative electrocardiography from digitized paper electrocardiograms: A new avenue for risk stratification in patients with Brugada syndrome. Archives of cardiovascular diseases, 2024, 117 (10), pp.558-612. ⟨10.1016/j.acvd.2024.05.123⟩. ⟨hal-04753406⟩
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