First description of a Brugada phenocopy in the inferior leads in the context of an acute inferior myocardial infarction
Bibliographic record
Abstract
A 67-year-old male patient with no prior medical cardiac history presented to the emergency department with anginal chest pain lasting for 1 h. His electrocardiographic (ECG) revealed ST-segment elevation in leads II, III, and aVF (Figure, A). A diagnosis of acute inferior myocardial infarction was made and the patient was transferred to our Cath Lab for a coronary angiography that revealed right coronary artery (RCA) occlusion in the mid segment and 50% stenosis of the circumflex artery (CX). Personal or family history of unexplained syncope, sudden cardiac death, or implantable cardiac defibrillator implantation was denied. Initial blood tests were normal except increased high sensitive troponin I: 24.98 ng/mL (0.002–0.0342). The patient presented polymorphic ventricular tachycardia (VT) with haemodynamic deterioration (Figure B). He was successfully defibrillated. Following defibrillation, the ECG revealed typical type-1 Brugada pattern in leads II, III, and aVF (Figure C). Electrolytes were normal and the patient was not receiving any medication known to trigger a Brugada ECG pattern. A new coronary angiogram showed a patent stent to the RCA and no progression of the CX lesion. The ECG normalized spontaneously immediately after the angiogram (Figure, D). A provocative test with ajmaline was performed 2 days later which failed to induce a type-1 Brugada ECG pattern. The full-length version of this report can be viewed at: http://www.escardio.org/Guidelines-&-Education/E-learning/Clinical-cases/Electrophysiology/EP-Case-Reports.
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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 | 0.007 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.007 | 0.006 |
| Insufficient payload (model declined to judge) | 0.002 | 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".