Abstract 17352: Predictors of Ventricular Arrhythmias and Sudden Death in a Quebec Cohort With Brugada Syndrome
Bibliographic record
Abstract
Introduction: Patients with Brugada syndrome (BrS) are at risk for ventricular arrhythmias (VAs) and sudden death. Identification of high-risk individuals beyond those with syncope or resuscitated SCD remains a major challenge. We sought to assess the value of clinical, electrophysiological, and ECG features of depolarization and repolarization in predicting arrhythmic events and SCD in a Quebec population. Methods: Consecutive patients with BrS diagnosed between 2002 and 2013 were recruited from three major university hospitals in the province of Quebec, Canada. Relevant clinical features were recorded at baseline. Qualifying ECGs with the highest type 1 ST-segment elevations were reviewed and analyzed by two electrophysiologists blinded to clinical history, with the following parameters assessed: S duration in V1, aVR sign, QRS duration in V6, R-J interval in V2, maximal Tp-e, duration, Tp-e dispersion, QRS-f, ST elevation and QTc in V2, and presence of an inferolateral ER pattern. Survival analyses considered a left truncation model to account for potential sampling bias, considering that those who died suddenly before recognition of BrS were necessarily excluded. Results: A total of 105 consecutive patients, 79.8% male, were diagnosed with BrS at a median age of 48 years and were followed for 5.0±1.2 years. Ten (9.5%) had a history of SCD, 37 (35.2%) had syncope, and 7 (6.7%) experienced 20 arrhythmic events during follow-up (7 anti-tachycardia pacing; 13 shocks). In multivariate Cox regression analyses adjusted for left truncation and Firth bias correction, a spontaneous type I ECG pattern (HR 10.80; 95% CI 1.03 to 113.87; p=0.0476)], maximal Tp-e duration ≥100ms (HR 29.73; 95% CI 1.33 to 666.37; p= 0.0325) and QRS duration in V6>110 ms (HR 15.27; 95% CI 1.07 to 217.42; p=0.0443) were independently associated with VAs or aborted SCD. Family history of SCD, AF, and inducible VAs during programmed ventricular stimulation were not associated with the primary endpoint. Conclusion: In a cohort of patients with BrS from the province of Quebec, VAs and SCD were independently associated with standard 12-lead ECG features including a spontaneous type 1 pattern, depolarization (QRS in V6 >110 ms), and repolarization (maximal Tp-e duration) criteria.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
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".