Channelopathies in children in Northern Ireland 2005–2023: A national cohort study identified primarily via cascade screening
Bibliographic record
Abstract
Background The inherited cardiac channelopathies are a diverse range of conditions caused by genetic variants that predispose carriers to arrhythmia and sudden cardiac death (SCD). Examples include Congenital Long QTc (LQTS), Brugada syndrome (BrS) and Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT). Objective In the Northern Ireland paediatric population, served by one inherited cardiac conditions clinic (ICCC) we describe the national prevalence and incidence of the channelopathies, clinical outcomes, adverse events, medication usage, medication adherence and genetic data obtained. Methods Retrospective chart review using the local paediatric cardiology database. Results 216 children (Aged 0–18) were diagnosed with a channelopathy between 2005 and 2023 at the ICCC; 190 were diagnosed with LQTS (116 KCNQ1, 36 KCNH2, 11 SCN5A, 19 KCNE1, 3 patients with variants in two genes, 1 compound heterozygote for KCNE1 and 4 genotype negative), 22 with BrS and 4 with CPVT. Most cases were diagnosed via screening (95 %). There were five documented SCDs during this time, all patients unknown to the ICCC, who were diagnosed with channelopathies on molecular autopsy (2 CPVT, 2 BrS, 1 LQTS). One KCNH2 patient underwent implantable cardioverter defibrillator (ICD) insertion. In the LQTS cohort the majority had a variant identified (97 %) Twenty-two variants were identified in KCNQ1 patients, fourteen variants in KCNH2, two in SCN5A and seven in KCNE1. As would be expected phenotype heterogeneity was noted between and within variants. Adherence with medication varied between 70 and 90 %. Conclusions In general, children with channelopathies in Northern Ireland (NI) are diagnosed via family screening, commenced on appropriate pharmacotherapy and adverse events are rare. The genetic profile is broadly similar to that reported worldwide. Unfortunately, there remains a cohort of patients who are only identified at molecular autopsy.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".