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Gorenek B, Boriani G, Dan GA, Fauchier L, Fenelon G, Huang H, Kudaiberdieva G, Lip GYH, Mahajan R, Potpara T, Ramirez JD, Vos MA, Marin F, Blomstrom-Lundqvist C, Rinaldi A, Bongiorni MG, Sciaraffia E, Nielsen JC, Lewalter T, Zhang S, Gutiérrez O, Fuenmayor A. European Heart Rhythm Association (EHRA) position paper on arrhythmia management and device therapies in endocrine disorders, endorsed by Asia Pacific Heart Rhythm Society (APHRS) and Latin American Heart Rhythm Society (LAHRS). Europace 2018; 20:895-896. [DOI: 10.1093/europace/euy051] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 02/25/2018] [Indexed: 12/18/2022] Open
Affiliation(s)
| | - Giuseppe Boriani
- Cardiology Division, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Gheorge-Andrei Dan
- University of Medicine and Pharmacy “Carol Davila”, Colentina University Hospital, Bucharest, Romania
| | - Laurent Fauchier
- Centre Hospitalier Universitaire Trousseau et Université François Rabelais, Tours, France
| | | | - He Huang
- Renmin Hospital of Wuhan University, Wuhan, China
| | | | - Gregory Y H Lip
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
- Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Rajiv Mahajan
- The University of Adelaide, Lyell McEwin Hospital, Royal Adelaide Hospital and SAHMRI, Adelaide, Australia
| | - Tatjana Potpara
- School of Medicine, Belgrade University; Cardiology Clinic, Clinical Centre of Serbia, Belgrade, Serbia
| | | | | | | | | | | | | | | | | | | | - Shu Zhang
- Beijing Fuwai Hospital, Beijing, China
| | | | - Abdel Fuenmayor
- Electrophysiology and Arrhythmia Section, Cardiovascular Research Institute, University Hospital of The Andes, Avenida 16 de Septiembre, Mérida 5101, Venezuela
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Tomé G, Freitas J. Induced Brugada syndrome: Possible sources of arrhythmogenesis. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.repce.2017.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Gottschalk BH, Anselm DD, Brugada J, Brugada P, Wilde AA, Chiale PA, Pérez-Riera AR, Elizari MV, De Luna AB, Krahn AD, Tan HL, Postema PG, Baranchuk A. Expert cardiologists cannot distinguish between Brugada phenocopy and Brugada syndrome electrocardiogram patterns. Europace 2015; 18:1095-100. [PMID: 26498159 DOI: 10.1093/europace/euv278] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 07/21/2015] [Indexed: 12/13/2022] Open
Abstract
AIMS Brugada phenocopies (BrPs) are electrocardiogram (ECG) patterns that are identical to true Brugada syndrome (BrS) but are induced by various clinical conditions. The concept that both ECG patterns are visually identical has not been formally demonstrated. The aim of our study was to determine if experts on BrS were able to accurately distinguish between the BrS and BrP ECG patterns. METHODS AND RESULTS Six ECGs from confirmed cases of BrS and six ECGs from previously published cases of BrP were included in the study. Surface 12-lead ECGs were scanned, saved in JPEG format, and sent to 10 international experts on BrS for evaluation (no clinical history provided). Evaluators were asked to label each case as a Brugada ECG pattern or non-Brugada ECG pattern by visual interpretation alone. The overall accuracy was 53 ± 33% for all cases. Within the BrS cases, the mean accuracy was 63 ± 34% and within the BrP cases, the mean accuracy was 43 ± 33%. Intra-observer repeatability was moderate (κ = 0.56) and inter-observer agreement was fair (κ = 0.36) while evaluator accuracy vs. the true diagnosis was only marginally better than chance (κ = 0.05). Similarly, diagnostic operating characteristics were poor (sensitivity 62%, specificity 43%, +LR 1.1, -LR 0.9). CONCLUSION Our results provide strong evidence that BrP and BrS ECG patterns are visually identical and indistinguishable. These findings support the use of systematic diagnostic criteria for differentiating BrP vs. BrS as an erroneous diagnosis may have a negative impact on patient morbidity and mortality.
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Affiliation(s)
- Byron H Gottschalk
- Department of Cardiology, Cardiac Electrophysiology and Pacing, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada K7L 2V7
| | - Daniel D Anselm
- Department of Cardiology, Cardiac Electrophysiology and Pacing, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada K7L 2V7
| | - Josep Brugada
- Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Pedro Brugada
- Heart Rhythm Management Center, UZ Brussels-VUB, Brussels, Belgium
| | - Arthur A Wilde
- Heart Centre AMC, Department of Clinical and Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders, Jeddah, Kingdom of Saudi Arabia
| | - Pablo A Chiale
- Division of Cardiology, Hospital Ramos Mejia, Buenos Aires, Argentina
| | - Andres R Pérez-Riera
- Cardiology Discipline, ABC Medical Faculty, ABC Foundation, Santo André, São Paulo, Brazil
| | - Marcelo V Elizari
- Division of Cardiology, Hospital Ramos Mejia, Buenos Aires, Argentina
| | - Antoni Bayés De Luna
- Cardiovascular Research Center, CSIC-ICCC, Hospital de la Santa CreuiSant Pau, Barcelona, Spain
| | - Andrew D Krahn
- Division of Cardiology, University of British Columbia, Vancouver, BC, Canada
| | - Hanno L Tan
- Heart Centre AMC, Department of Clinical and Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Pieter G Postema
- Heart Centre AMC, Department of Clinical and Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Adrian Baranchuk
- Department of Cardiology, Cardiac Electrophysiology and Pacing, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada K7L 2V7
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