Cited by 581Cardiac electrophysiology and arrhythmiasCardiac Arrhythmias and TreatmentsCardiac pacing and defibrillation studies

Risk Stratification in Brugada Syndrome

Open access
Priori, Silvia G., Gasparini, Maurizio, Napolitano, Carlo, Della Bella, Paolo, Ottonelli, Andrea Ghidini, Sassone, Biagio, Giordano, Umberto, Pappone, Carlo +4 more·2012·Journal of the American College of Cardiology

Abstract

Objectives The PRELUDE (PRogrammed ELectrical stimUlation preDictive valuE) prospective registry was designed to assess the predictive accuracy of sustained ventricular tachycardia/ventricular fibrillation (VTs/VF) inducibility and to identify additional predictors of arrhythmic events in Brugada syndrome patients without history of VT/VF.Background Brugada syndrome is a genetic disease associated with increased risk of sudden cardiac death. Even though its value has been questioned, inducibility of VTs/VF is widely used to select candidates to receive a prophylactic implantable defibrillator, and its accuracy has never been addressed in prospective studies with homogeneous enrolling criteria.Methods Patients with a spontaneous or drug-induced type I electrocardiogram (ECG) and without history of cardiac arrest were enrolled. The registry included 308 consecutive individuals (247 men, 80%; median age 44 years, range 18 to 72 years). Programmed electrical stimulation was performed at enrollment, and patients were followed-up every 6 months.Results During a median follow-up of 34 months, 14 arrhythmic events (4.5%) occurred (13 appropriate shocks of the implantable defibrillator, and 1 cardiac arrest). Programmed electrical stimulation performed with a uniform and pre-specified protocol induced ventricular tachyarrhythmias in 40% of patients: arrhythmia inducibility was not a predictor of events at follow-up (9 of 14 events occurred in noninducible patients). History of syncope and spontaneous type I ECG (hazard ratio [HR]: 4.20), ventricular refractory period <200 ms (HR: 3.91), and QRS fragmentation (HR: 4.94) were significant predictors of arrhythmias.Conclusions Our data show that VT/VF inducibility is unable to identify high-risk patients, whereas the presence of a spontaneous type I ECG, history of syncope, ventricular effective refractory period <200 ms, and QRS fragmentation seem useful to identify candidates for prophylactic implantable cardioverter defibrillator.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.jacc.2011.08.064

Cites

26 of 26 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A drug-induced type 1 ECG pattern has a lower risk of sudden death than a spontaneous type 1 response in Brugada syndrome.

    “A drug-induced type 1 ECG pattern has a lower risk of sudden death than a spontaneous type 1 response.”

    From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [371]

    The PRELUDE Registry’s risk-stratification discussion reports more than fourfold higher risk of an arrhythmic event with a spontaneous type I ECG than without one, and notes that only one patient without a spontaneous pattern had a cardiac arrest. This supports the direction of the comparison, but the study measured arrhythmic events—mostly defibrillator shocks—not sudden-death rates specifically. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Brugada J, Brugada R, Brugada P. Right bundle-branch block and ST-segment elevation in leads V1 through V3: a marker for sudden death in patients without demonstrable structural heart disease. Cir- culation 1998;97:457-60.

Cited by

Sorted by citations

Authors
Priori, S. G., Gasparini, M., Napolitano, C., Della Bella, P., Ottonelli, A. G., Sassone, B., Giordano, U., Pappone, C., Mascioli, G., Rossetti, G., De Nardis, R., & Colombo, M.
Affiliations
  • University of Pavia (IT)
  • IRCCS Humanitas Research Hospital (IT)
  • NYU Langone Health (US)
  • Ospedale Versilia (IT)
  • Azienda USL di Bologna (IT)
  • Maria Cecilia Hospital (IT)
  • Humanitas Gavazzeni (IT)
  • Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo (IT)
Corresponding author
Priori, Silvia G.
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2012-01
Volume
59
Issue
1
Pages
37-45
ISSN
0735-1097 (ISSN-L)
OpenAlex
W140924846
Cited by
581
References
26
Citations by year
2026: 13 · 2025: 14 · 2024: 26 · 2023: 25 · 2022: 26 · 2021: 44 · 2020: 43 · 2019: 44 · 2018: 44 · 2017: 68 · 2016: 60 · 2015: 45 · 2014: 31 · 2013: 66 · 2012: 30
FWCI
28.05
Type
journal article
Language
en
Open access
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
  • Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion)
Funders
  • Medtronic
  • Boston Scientific Corporation
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
Keywords
Brugada syndrome, risk stratification, programmed electrical stimulation, implantable cardioverter-defibrillator, sudden cardiac death, syncope, ventricular effective refractory period, QRS fragmentation, arrhythmic events
MeSH terms
Adolescent, Adult, Aged, Cause of Death, Electric Stimulation, Electrocardiography, Female, Humans, Male, Middle Aged, Registries, Severity of Illness Index, Ventricular Fibrillation, Cohort Studies, Incidence, Survival Rate, Confidence Intervals, Defibrillators, Implantable, Tachycardia, Ventricular, Age Distribution, Sex Distribution, Risk Assessment, Patient Selection, Statistics, Nonparametric, Kaplan-Meier Estimate, Brugada Syndrome, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review