{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T10:21:48Z","timestamp":1777285308832,"version":"3.51.4"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T00:00:00Z","timestamp":1610582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Patients suffering from Brugada syndrome (BrS) are at an increased risk of life-threatening ventricular arrhythmias. Whilst electrocardiographic (ECG) variables have been used for risk stratification with varying degrees of success, automated measurements have not been tested for their ability to predict adverse outcomes in BrS.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> BrS patients presenting in a single tertiary center between 2000 and 2018 were analyzed retrospectively. ECG variables on vector magnitude, axis, amplitude and duration from all 12 leads were determined. The primary endpoint was spontaneous ventricular tachycardia\/ventricular fibrillation (VT\/VF) on follow-up.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> This study included 83 patients [93% male, median presenting age: 56 (41\u201366) years old, 45% type 1 pattern] with 12 developing the primary endpoint (median follow-up: 75 (Q1\u2013Q3: 26\u2013114 months). Cox regression showed that QRS frontal axis &amp;gt; 70.0 degrees, QRS horizontal axis &amp;gt; 57.5 degrees, R-wave amplitude (lead I) &amp;lt;0.67 mV, R-wave duration (lead III) &amp;gt; 50.0 ms, S-wave amplitude (lead I) &amp;lt; \u22120.144 mV, S-wave duration (lead aVL) &amp;gt; 35.5 ms, QRS duration (lead V3) &amp;gt; 96.5 ms, QRS area in lead I &amp;lt; 0.75 Ashman units, ST slope (lead I) &amp;gt; 31.5 deg, T-wave area (lead V1) &amp;lt; \u22123.05 Ashman units and PR interval (lead V2) &amp;gt; 157 ms were significant predictors. A weighted score based on dichotomized values provided good predictive performance (hazard ratio: 1.59, 95% confidence interval: 1.27\u20132.00, <jats:italic>P<\/jats:italic>-value&amp;lt;0.0001, area under the curve: 0.84).<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Automated ECG analysis revealed novel risk markers in BrS. These markers should be validated in larger prospective studies.<\/jats:p>","DOI":"10.3389\/fcvm.2020.618254","type":"journal-article","created":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T13:21:15Z","timestamp":1610630475000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Automated Electrocardiogram Analysis Identifies Novel Predictors of Ventricular Arrhythmias in Brugada Syndrome"],"prefix":"10.3389","volume":"7","author":[{"given":"Gary","family":"Tse","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharen","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guangping","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiandong","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingpeng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,1,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1038\/nrcardio.2016.143","article-title":"Pathogenesis and management of Brugada syndrome","volume":"13","author":"Sieira","year":"2016","journal-title":"Nat Rev Cardiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1016\/j.acvd.2016.09.009","article-title":"Brugada syndrome: diagnosis, risk stratification and management","volume":"110","author":"Gourraud","year":"2017","journal-title":"Arch Cardiovasc Dis"},{"key":"B3","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.ijcha.2018.03.001","article-title":"High risk electrocardiographic markers in Brugada syndrome","volume":"18","author":"Asvestas","year":"2018","journal-title":"Int J Cardiol Heart Vasc"},{"key":"B4","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.jacc.2011.08.064","article-title":"Risk stratification in Brugada syndrome: results of the PRELUDE (PRogrammed ELectrical stimUlation preDictive valuE) registry","volume":"59","author":"Priori","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e005928","DOI":"10.1161\/CIRCEP.117.005928","article-title":"Right ventricular outflow tract electroanatomical abnormalities predict ventricular fibrillation inducibility in Brugada Syndrome","volume":"11","author":"Letsas","year":"2018","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"972","DOI":"10.1093\/europace\/euaa003","article-title":"Indication and prognostic significance of programmed ventricular stimulation in asymptomatic patients with Brugada syndrome","volume":"22","author":"Asada","year":"2020","journal-title":"Europace"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2920","DOI":"10.22541\/au.159225401.16289810","article-title":"Low rate of life-threatening events and limitations in predicting invasive and non-invasive markers of symptoms in a cohort of type 1 Brugada syndrome patients. 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