Evidence map›Paper›PMID 40861250›Full record

ArticleJournal of arrhythmia2025

Automated Assessment to Predict Lethal Arrhythmias in Brugada Syndrome: Significance of R' in Lead III.

Daiki Shako, Satoshi Nagase, Naoya Kataoka, Toshihiro Nakamura, Satoshi Oka, Yuichiro Miyazaki, Akinori Wakamiya, Kenzaburo Nakajima, Nobuhiko Ueda, Tsukasa Kamakura and 6 more

Abstract read
In one paragraph

Article in Journal of arrhythmia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Daiki ShakoDepartment of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.
Satoshi NagaseDepartment of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.ORCID https://orcid.org/0000-0001-7894-0914
Naoya KataokaSecond Department of Internal Medicine University of Toyama Toyama Japan.ORCID https://orcid.org/0000-0001-7097-2495
Toshihiro NakamuraDepartment of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.
Satoshi OkaDepartment of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.
Yuichiro MiyazakiDepartment of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.ORCID https://orcid.org/0000-0003-0407-7286
Akinori WakamiyaDepartment of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.
Kenzaburo NakajimaDepartment of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.
Nobuhiko UedaDepartment of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.ORCID https://orcid.org/0000-0002-7862-3967
Tsukasa KamakuraDepartment of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.
Mitsuru WadaDepartment of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.
Kohei IshibashiDepartment of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.
Yuko InoueDepartment of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.
Koji MiyamotoDepartment of Advanced Arrhythmia and Translational Medical Science National Cerebral and Cardiovascular Center Suita Japan.ORCID https://orcid.org/0000-0003-1728-0240
Takeshi AibaDepartment of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.
Kengo KusanoDepartment of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.ORCID https://orcid.org/0000-0002-5760-9285

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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.

Indexed as

Brugada syndromeelectrocardiogramepicardial mappingfragmentationsudden cardiac arrestventricular fibrillation

Identifiers

PMID40861250
PMCPMC12375977

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.