Investigation on Prediction of Life-Threatening Arrhythmia in Long QT Syndrome : A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Introduction : Use of risk stratification tools in Long QT Syndrome (LQTS) will be important to direct treatment strategy on each patient and risk of arrhythmia. There are still other factor that could improve the predictive performance of the risk stratification. This study aims to find a new predictor of Life-Threatening Arrhythmia in the LQTS population. Methods : Based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA) Protocol 2015, studies extracted from Pubmed, Science Direct, Pubmed Central, EuroPMC, Frontiers with MeSH keywords “Long QT Syndrome AND Predictor AND Life-threatening arrhythmia”. The inclusion criteria were cohort studies in LQTS patients (LQT 1, 2, 3) and the endpoint was life-threatening arrhythmia such as aborted cardiac arrest or sudden cardiac death. Study quality assessed with Newcastle-Ottawa Scale and RevMan 5.4 were used to analyse the data with hazard ratio as the measures. Results : Six cohort studies (12.343 subjects) fulfilled the inclusion criteria. Male <13 years old (HR = 2.73, 95% CI = 1.72-4.33, p = <0.0001) and female >13 years old (HR = 1.81, 95% CI = 1.36-2.41, p = <0.0001) were significant as predictor of life-threatening arrhythmia. Patients with LQT2 (HR = 1.84, 95% CI = 1.36-2.49, p = <0.0001), LQT3 genotype (HR = 3.88, 95% CI = 2.27-6.62, p = <0.00001), and QTc >530 (HR = 2.45, 95% CI = 1.96-3.06, p <0.00001) were also at increased risk of life-threatening arrhythmia. Syncope occurrence increased the risk (HR = 3.11, 95% CI = 2.47-3.91, p = <0.00001) while beta-blockers usage significantly decreased the risk of life-threatening arrhythmia (HR = 0.46, 95% CI = 0.36-0.60, p = <0.00001). All studies were low risk of bias. Conclusion : There were other predictors of life-threatening arrhythmia in LQTS that might be considered to improve the stratification performance. -- Highlights: 1. In patients with Long QT Syndrome, life-threatening arrhythmia risk is strongly predicted by age-dependent gender differences, prolonged QTc (>530 ms), prior syncope, genotype (LQT2/3), and mitigated by beta-blocker use—offering a sharper edge for clinical risk stratification.
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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 | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.024 | 0.016 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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; both teacher heads agree on what is shown here.
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".