{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:36:57Z","timestamp":1780447017091,"version":"3.54.1"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T00:00:00Z","timestamp":1623628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"European Union's Horizon 2020 research and innovation programme","award":["733381"],"award-info":[{"award-number":["733381"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>In patients with Brugada syndrome (BrS) but without spontaneous Type-1 electrocardiogram, several electrocardiographic characteristics have been studied, including the \u03b2-angle. Previous studies suggested that the \u03b2-angle might be useful in distinguishing BrS-patients from patients with only suggestive repolarization patterns without performing sodium channel blocker provocation testing. In this study, we aimed to determine the diagnostic value of the \u03b2-angle in patients suspected of BrS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>A large cohort (n\u2009=\u20091430) of consecutive patients who underwent provocation testing was evaluated. \u03b2-angles were measured in leads V1, V2, and their corresponding positions over the second and third intercostal space. Receiver-operating characteristic curves were constructed and the diagnostic accuracy of previously reported \u03b2-angle cut-offs were calculated and evaluated. The importance of the \u03b2-angle for predicting the provocation test outcome was determined using a prediction model constructed with logistic regression. The optimum \u03b2-angle cut-off in our cohort for ruling out a positive provocation test was 15\u00b0; sensitivities were 80\u201398% and negative predictive values were 79\u201396% among the right precordial leads. Previously reported \u03b2-angle cut-offs performed less well, indicated by lower Youden indices. In the optimism-corrected prediction model [C-statistic: 0.78 (95% CI: 0.75\u20130.81)], the \u03b2-angle had large value (Z-score: 2.1\u201310.3) and aided construction of a nomogram to predict test outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>To predict the outcome of provocation testing for BrS, the \u03b2-angle alone does not demonstrate strong diagnostic characteristics. However, the \u03b2-angle is an important variable to predict provocation test outcome and thus has added value.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euab128","type":"journal-article","created":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T21:23:35Z","timestamp":1620249815000},"page":"2020-2028","source":"Crossref","is-referenced-by-count":10,"title":["The \u03b2-angle can help guide clinical decisions in the diagnostic work-up of patients suspected of Brugada syndrome: a validation study of the \u03b2-angle in determining the outcome of a sodium channel provocation test"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2565-337X","authenticated-orcid":false,"given":"Martijn H","family":"van der Ree","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, Cardiovascular Sciences, Meibergdreef 9, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0172-5842","authenticated-orcid":false,"given":"Jeroen","family":"Vendrik","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, Cardiovascular Sciences, Meibergdreef 9, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4340-6815","authenticated-orcid":false,"given":"Tom E","family":"Verstraelen","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, Cardiovascular Sciences, Meibergdreef 9, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4929-026X","authenticated-orcid":false,"given":"Jan A","family":"Kors","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad S","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, Cardiovascular Sciences, Meibergdreef 9, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0528-0852","authenticated-orcid":false,"given":"Arthur A M","family":"Wilde","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, Cardiovascular Sciences, Meibergdreef 9, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7905-5818","authenticated-orcid":false,"given":"Hanno L","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, Cardiovascular Sciences, Meibergdreef 9, Amsterdam, The Netherlands"},{"name":"Netherlands Heart Institute, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2863-9159","authenticated-orcid":false,"given":"Pieter G","family":"Postema","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, Cardiovascular Sciences, Meibergdreef 9, Amsterdam, The 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