Abstract 10920: Programmed Ventricular Stimulation for Risk Stratification in the Brugada Syndrome: A Pooled Analysis
Bibliographic record
Abstract
Introduction: The role of programmed ventricular stimulation (PVS) in identifying Brugada syndrome patients at highest risk for sudden death is uncertain. Objective: To investigate the utility of PVS to predict future cardiac arrests or ICD therapy for ventricular arrhythmias in Brugada syndrome patients. Methods: We performed a systematic review and pooled analysis of prospective observational studies of Brugada syndrome patients with no history of sudden cardiac arrest who underwent PVS. We estimated incidence rates and relative hazards of cardiac arrest or ICD shock. Results: We analyzed individual-level data from 8 studies, comprising 1312 patients who experienced 65 cardiac events (median follow-up of 38.3 months). A total of 527 patients were induced into arrhythmias with up to triple extrastimuli. Induction was associated with cardiac events during follow-up (HR 2.66, 95%CI 1.44-4.92, P<0.001). Event risks were inversely proportional to the number of extrastimuli causing induction (HR for each fewer extrastimulus protocol relative to individuals not induced 1.69, 95%CI 1.25-2.29, P<0.001). Annual event rates varied substantially by syncope history, presence of spontaneous type 1 ECG pattern, and arrhythmia induction (0.23%, 95%CI 0.05-0.68 [no induced arrhythmia with up to double extrastimuli]; 0.45%, 95%CI 0.01-2.49 [induced arrhythmia]) and highest risk occurring among individuals with syncope and spontaneous type 1 patterns (2.55%, 95%CI 1.58-3.89 [no induced arrhythmia]; 5.60%, 95%CI 2.98-9.58 [induced arrhythmia]; ( Figure ). Conclusion: In Brugada syndrome patients, arrhythmias induced with PVS associate with future ventricular arrhythmia risk. Induction with fewer extrastimuli is associated with higher risk. However, clinical risk factors are important determinants of arrhythmia risk, and lack of induction does not necessarily portend low ventricular arrhythmia risk particularly in patients with high-risk clinical features.
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 | 0.019 | 0.030 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.013 | 0.035 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".