Increased Prevalence of the Electrocardiographic Early Repolarization Pattern in Young Patients With Vagally Mediated Syncope: A Case-Control Study
Bibliographic record
Abstract
BackgroundElectrocardiographic early repolarization (EER) is linked with idiopathic ventricular fibrillation in adults. It is frequently seen in children, with poorly understood significance. Some evidence suggests it could be a vagally mediated phenomenon. A retrospective case-control study was undertaken to test the hypothesis that EER is more common among children with typical vasovagal syncope (VVS) than among their peers with non-vagal syncope (NVS) or with no syncope.MethodsPatients aged 4-18 years with syncope were identified by a single-center database search followed by a review of history for features of VVS (n=150) or NVS (n=84). The first available ECG for VVS or for NVS was retrieved. Age- and sex-matched children with no known syncope or heart disease were then identified (n=216). ECGs were assessed separately for EER based on published criteria by two observers blinded to patients’ clinical status.ResultsMean age was 12.3 ± 3.2 years, and heart rate was 74.2 ± 16.5 beats/minute. EER was more prevalent in VVS (33.3%) than among patients with NVS (19.1%; OR 2.29, CI 1.32-5.50) or among those with no syncope (12.5%; OR 3.14, CI 1.81-5.46) . Heart rates were significantly lower in VVS and NVS (HR 70.1 ± 13.8 and 70.7 ± 12.4 beats/minute, respectively) compared to children with no syncope (HR 78.2 ± 18.0 beats/minute); both P<0.001.ConclusionEER is more common in pediatric patients with vasovagal syncope than those with non-vagal syncope or without syncope, consistent with a possible vagal contribution to the ECG finding.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".