{"title":"自动评估预测Brugada综合征致死性心律失常：铅ⅲR值的意义","authors":"Daiki Shako, Satoshi Nagase, Naoya Kataoka, Toshihiro Nakamura, Satoshi Oka, Yuichiro Miyazaki, Akinori Wakamiya, Kenzaburo Nakajima, Nobuhiko Ueda, Tsukasa Kamakura, Mitsuru Wada, Kohei Ishibashi, Yuko Inoue, Koji Miyamoto, Takeshi Aiba, Kengo Kusano","doi":"10.1002/joa3.70166","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Previous investigations of predictors of sudden cardiac arrest (SCA) in Brugada syndrome (BrS) have been conducted using manual electrocardiogram (ECG) measurement, which lacks objectivity. This study aimed to examine predictive factors for SCA in BrS using automated ECG measurements.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In 270 patients with BrS, ECGs were recorded using the same electrocardiograph when a Type 1 ECG was initially observed. The data were digitally acquired and analyzed using identical software. Right precordial leads in the upper one and two intercostal spaces were recorded in all patients.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>During a median follow-up of 88 months, 28 patients (10%) experienced SCA. Multivariate analysis showed that a history of SCA, history of syncope, R' duration ≥ 18 ms in lead III, and maximum corrected Tpeak-end interval ≥ 137 ms in right precordial leads were independent predictors of SCA. To simplify clinical verification, the presence of an R' wave in lead III was used as a cut-off surrogate. Visual evaluation confirmed that this R' wave remained an independent predictor of SCA in multivariate analysis. All seven patients with BrS who underwent epicardial mapping had fragmented potential at the base of the right ventricular inferior/inferolateral wall. This area corresponded to the most inferior and right-sided region of the ventricle, suggesting lead III may best reflect this region.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Automated ECG measurement revealed that an R' duration ≥ 18 ms in lead III predicted SCA in patients with BrS. Visual assessment also identified the R' wave in lead III as a novel predictor of SCA.</p>\n </section>\n </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70166","citationCount":"0","resultStr":"{\"title\":\"Automated Assessment to Predict Lethal Arrhythmias in Brugada Syndrome: Significance of R' in Lead III\",\"authors\":\"Daiki Shako, Satoshi Nagase, Naoya Kataoka, Toshihiro Nakamura, Satoshi Oka, Yuichiro Miyazaki, Akinori Wakamiya, Kenzaburo Nakajima, Nobuhiko Ueda, Tsukasa Kamakura, Mitsuru Wada, Kohei Ishibashi, Yuko Inoue, Koji Miyamoto, Takeshi Aiba, Kengo Kusano\",\"doi\":\"10.1002/joa3.70166\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Previous investigations of predictors of sudden cardiac arrest (SCA) in Brugada syndrome (BrS) have been conducted using manual electrocardiogram (ECG) measurement, which lacks objectivity. This study aimed to examine predictive factors for SCA in BrS using automated ECG measurements.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>In 270 patients with BrS, ECGs were recorded using the same electrocardiograph when a Type 1 ECG was initially observed. The data were digitally acquired and analyzed using identical software. Right precordial leads in the upper one and two intercostal spaces were recorded in all patients.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>During a median follow-up of 88 months, 28 patients (10%) experienced SCA. Multivariate analysis showed that a history of SCA, history of syncope, R' duration ≥ 18 ms in lead III, and maximum corrected Tpeak-end interval ≥ 137 ms in right precordial leads were independent predictors of SCA. To simplify clinical verification, the presence of an R' wave in lead III was used as a cut-off surrogate. Visual evaluation confirmed that this R' wave remained an independent predictor of SCA in multivariate analysis. All seven patients with BrS who underwent epicardial mapping had fragmented potential at the base of the right ventricular inferior/inferolateral wall. This area corresponded to the most inferior and right-sided region of the ventricle, suggesting lead III may best reflect this region.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Automated ECG measurement revealed that an R' duration ≥ 18 ms in lead III predicted SCA in patients with BrS. Visual assessment also identified the R' wave in lead III as a novel predictor of SCA.</p>\\n </section>\\n </div>\",\"PeriodicalId\":15174,\"journal\":{\"name\":\"Journal of Arrhythmia\",\"volume\":\"41 4\",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-08-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70166\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Arrhythmia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/joa3.70166\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Arrhythmia","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/joa3.70166","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Automated Assessment to Predict Lethal Arrhythmias in Brugada Syndrome: Significance of R' in Lead III
Background
Previous investigations of predictors of sudden cardiac arrest (SCA) in Brugada syndrome (BrS) have been conducted using manual electrocardiogram (ECG) measurement, which lacks objectivity. This study aimed to examine predictive factors for SCA in BrS using automated ECG measurements.
Methods
In 270 patients with BrS, ECGs were recorded using the same electrocardiograph when a Type 1 ECG was initially observed. The data were digitally acquired and analyzed using identical software. Right precordial leads in the upper one and two intercostal spaces were recorded in all patients.
Results
During a median follow-up of 88 months, 28 patients (10%) experienced SCA. Multivariate analysis showed that a history of SCA, history of syncope, R' duration ≥ 18 ms in lead III, and maximum corrected Tpeak-end interval ≥ 137 ms in right precordial leads were independent predictors of SCA. To simplify clinical verification, the presence of an R' wave in lead III was used as a cut-off surrogate. Visual evaluation confirmed that this R' wave remained an independent predictor of SCA in multivariate analysis. All seven patients with BrS who underwent epicardial mapping had fragmented potential at the base of the right ventricular inferior/inferolateral wall. This area corresponded to the most inferior and right-sided region of the ventricle, suggesting lead III may best reflect this region.
Conclusion
Automated ECG measurement revealed that an R' duration ≥ 18 ms in lead III predicted SCA in patients with BrS. Visual assessment also identified the R' wave in lead III as a novel predictor of SCA.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
