Computerized automated algorithm-based analyses of digitized paper ECGs in Brugada syndrome

Brugada syndrome is a rare inherited arrhythmic syndrome with a coved type 1 ST-segment elevation on ECG and an increased risk of sudden death. Many studies have evaluated risk stratification performance based on ECG-derived parameters. However, since historical Brugada patient cohorts included most...

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Bibliographic Details
Published in:Journal of electrocardiology 2021-11, Vol.69 (7), p.61-66
Main Authors: Extramiana, Fabrice, Laporte, Pierre-Léo, Vaglio, Martino, Denjoy, Isabelle, Maison-Blanche, Pierre, Badilini, Fabio, Leenhardt, Antoine
Format: Article
Language:English
Subjects:
Adult
Algorithms
Anti-Arrhythmia Agents - therapeutic use
Automation
Brugada syndrome
Brugada Syndrome - diagnosis
Brugada Syndrome - drug therapy
Cardiac arrhythmia
Computerized analysis
Digitization
ECG
Electrocardiography
Female
Humans
Life Sciences
Male
Medical technology
Middle Aged
Software
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Summary:Brugada syndrome is a rare inherited arrhythmic syndrome with a coved type 1 ST-segment elevation on ECG and an increased risk of sudden death. Many studies have evaluated risk stratification performance based on ECG-derived parameters. However, since historical Brugada patient cohorts included mostly paper ECGs, most studies have been based on manual ECG parameter measurements. We hypothesized that it would be possible to run automated algorithm-based analysis of paper ECGs. We aimed: 1) to validate the digitization process for paper ECGs in Brugada patients; and 2) to quantify the acute class I antiarrhythmic drug effect on relevant ECG parameters in Brugada syndrome. A total of 176 patients (30% female, 43 ± 13 years old) with induced type 1 Brugada syndrome ECG were included in the study. All of the patients had paper ECGs before and during class I antiarrhythmic drug challenge. Twenty patients also had a digital ECG, in whom printouts were used to validate the digitization process. Paper ECGs were scanned and then digitized using ECGScan software, version 3.4.0 (AMPS, LLC, New York, NY, USA) to obtain FDA HL7 XML format ECGs. Measurements were automatically performed using the Bravo (AMPS, LLC, New York, NY, USA) and Glasgow algorithms. ECG parameters obtained from digital and digitized ECGs were closely correlated (r = 0.96 ± 0.07, R2 = 0.93 ± 0.12). Class I antiarrhythmic drugs significantly increased the global QRS duration (from 113 ± 20 to 138 ± 23, p 
ISSN:0022-0736
1532-8430
DOI:10.1016/j.jelectrocard.2021.09.009