Exercise-induced right bundle branch block progressive resolution
Bibliographic record
Abstract
A 67-year-old male was presented to the consultant with atypical chest pain. A stress test was performed. Panel A shows a 12-lead electrocardiogram (ECG) immediately before the test, depicting a normal sinus rhythm at 83 b.p.m. and right bundle branch block (RBBB). Panel B shows the heart rate increasing to a maximum of 117 b.p.m. with complete resolution of RBBB. What are the possible mechanisms? First, one should speculate that a rapid and progressive increment of plasmatic catecholamines occurred, leading to a progressive shortening of the right bundle branch refractory period facilitating 2 : 1 conduction first, and then complete normalization of conduction. Secondly, possible supernormality of conduction (SNC) over the right bundle branch may be occurring given that the PR interval remains stable. This is very difficult to prove without a complete screening of the diastolic period at different heart rates. Finally, Phase 4 RBBB was ruled out by observing several prior ECGs at lower heart rates, depicting RBBB identical to the one observed during the stress test. The full-length version of this report can be viewed at: http://www.escardio.org/communities/EHRA/publications/ep-case-reports/Documents/exercise-induced-right-bundle.pdf.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".