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Development of an electrocardiogram-based risk calculator for a cardiac cause of syncope

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Development of an electrocardiogram-based risk calculator for a cardiac cause of syncope. / Zimmermann, Tobias; du Fay de Lavallaz, Jeanne; Walter, Joan Elias; Strebel, Ivo; Nestelberger, Thomas; Joray, Lydia; Badertscher, Patrick; Flores, Dayana; Widmer, Velina; Geigy, Nicolas; Miro, Oscar; Salgado, Emilio; Christ, Michael; Cullen, Louise; Than, Martin; Martín-Sánchez, Francisco Javier; Di Somma, Salvatore; Peacock, W Frank; Keller, Dagmar; Costabel, Juan Pablo; Wussler, Desiree Nadine; Kawecki, Damian; Lohrmann, Jens; Gualandro, Danielle Menosi; Kuehne, Michael; Reichlin, Tobias; Sun, Benjamin; Mueller, Christian; BASEL IX and SRS Investigators.

In: HEART, Vol. 107, No. 22, 11.2021, p. 1796-1804.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Zimmermann, T, du Fay de Lavallaz, J, Walter, JE, Strebel, I, Nestelberger, T, Joray, L, Badertscher, P, Flores, D, Widmer, V, Geigy, N, Miro, O, Salgado, E, Christ, M, Cullen, L, Than, M, Martín-Sánchez, FJ, Di Somma, S, Peacock, WF, Keller, D, Costabel, JP, Wussler, DN, Kawecki, D, Lohrmann, J, Gualandro, DM, Kuehne, M, Reichlin, T, Sun, B, Mueller, C & BASEL IX and SRS Investigators 2021, 'Development of an electrocardiogram-based risk calculator for a cardiac cause of syncope', HEART, vol. 107, no. 22, pp. 1796-1804. https://doi.org/10.1136/heartjnl-2020-318430

APA

Zimmermann, T., du Fay de Lavallaz, J., Walter, J. E., Strebel, I., Nestelberger, T., Joray, L., Badertscher, P., Flores, D., Widmer, V., Geigy, N., Miro, O., Salgado, E., Christ, M., Cullen, L., Than, M., Martín-Sánchez, F. J., Di Somma, S., Peacock, W. F., Keller, D., ... BASEL IX and SRS Investigators (2021). Development of an electrocardiogram-based risk calculator for a cardiac cause of syncope. HEART, 107(22), 1796-1804. https://doi.org/10.1136/heartjnl-2020-318430

Vancouver

Zimmermann T, du Fay de Lavallaz J, Walter JE, Strebel I, Nestelberger T, Joray L et al. Development of an electrocardiogram-based risk calculator for a cardiac cause of syncope. HEART. 2021 Nov;107(22):1796-1804. https://doi.org/10.1136/heartjnl-2020-318430

Bibtex

@article{f149b6346ac6446298b7f3e9232bc16f,
title = "Development of an electrocardiogram-based risk calculator for a cardiac cause of syncope",
abstract = "OBJECTIVE: To develop an ECG-based tool for rapid risk assessment of a cardiac cause of syncope in patients ≥40 years.METHODS: In a prospective international multicentre study, 2007 patients ≥40 years presenting with syncope were recruited in the emergency department (ED) of participating centres ranging from large university hospitals to smaller rural hospitals in eight countries from May 2010 to July 2017. 12-Lead ECG recordings were obtained at ED presentation following the syncopal event. The primary diagnostic outcome, a cardiac cause of syncope, was centrally adjudicated by two independent cardiologists using all available clinical information including 12-month follow-up. ECG predictors for a cardiac cause of syncope were identified using penalised backward selection and a continuous-scale likelihood was calculated based on regression analysis coefficients. Findings were validated in an independent US multicentre cohort including 2269 patients.RESULTS: In the derivation cohort, a cardiac cause of syncope was adjudicated in 267 patients (16%). Seven ECG criteria were identified as predictors for this outcome: heart rate and QTc-interval (continuous predictors), rhythm, atrioventricular block, ST-segment depression, bundle branch block and ventricular extrasystole/non-sustained ventricular tachycardia (categorical predictors). Diagnostic accuracy of these combined predictors for a cardiac cause of syncope was high (area under the curve 0.80, 95% CI 0.77 to 0.83). Overall, 138 patients (8%) were rapidly triaged towards rule-out and 181 patients (11%) towards rule-in of a cardiac cause of syncope. External validation showed similar performance.CONCLUSION: In patients ≥40 years with a syncopal event, a combination of seven ECG criteria enabled rapid assessment of the likelihood that syncope was due to a cardiac cause.TRIAL REGISTRATION NUMBER: NCT01548352 (BASEL IX), NCT01802398 (SRS study).",
author = "Tobias Zimmermann and {du Fay de Lavallaz}, Jeanne and Walter, {Joan Elias} and Ivo Strebel and Thomas Nestelberger and Lydia Joray and Patrick Badertscher and Dayana Flores and Velina Widmer and Nicolas Geigy and Oscar Miro and Emilio Salgado and Michael Christ and Louise Cullen and Martin Than and Mart{\'i}n-S{\'a}nchez, {Francisco Javier} and {Di Somma}, Salvatore and Peacock, {W Frank} and Dagmar Keller and Costabel, {Juan Pablo} and Wussler, {Desiree Nadine} and Damian Kawecki and Jens Lohrmann and Gualandro, {Danielle Menosi} and Michael Kuehne and Tobias Reichlin and Benjamin Sun and Christian Mueller and {BASEL IX and SRS Investigators}",
note = "{\textcopyright} Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2021",
month = nov,
doi = "10.1136/heartjnl-2020-318430",
language = "English",
volume = "107",
pages = "1796--1804",
journal = "HEART",
issn = "1355-6037",
publisher = "BMJ PUBLISHING GROUP",
number = "22",

}

RIS

TY - JOUR

T1 - Development of an electrocardiogram-based risk calculator for a cardiac cause of syncope

AU - Zimmermann, Tobias

AU - du Fay de Lavallaz, Jeanne

AU - Walter, Joan Elias

AU - Strebel, Ivo

AU - Nestelberger, Thomas

AU - Joray, Lydia

AU - Badertscher, Patrick

AU - Flores, Dayana

AU - Widmer, Velina

AU - Geigy, Nicolas

AU - Miro, Oscar

AU - Salgado, Emilio

AU - Christ, Michael

AU - Cullen, Louise

AU - Than, Martin

AU - Martín-Sánchez, Francisco Javier

AU - Di Somma, Salvatore

AU - Peacock, W Frank

AU - Keller, Dagmar

AU - Costabel, Juan Pablo

AU - Wussler, Desiree Nadine

AU - Kawecki, Damian

AU - Lohrmann, Jens

AU - Gualandro, Danielle Menosi

AU - Kuehne, Michael

AU - Reichlin, Tobias

AU - Sun, Benjamin

AU - Mueller, Christian

AU - BASEL IX and SRS Investigators

N1 - © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2021/11

Y1 - 2021/11

N2 - OBJECTIVE: To develop an ECG-based tool for rapid risk assessment of a cardiac cause of syncope in patients ≥40 years.METHODS: In a prospective international multicentre study, 2007 patients ≥40 years presenting with syncope were recruited in the emergency department (ED) of participating centres ranging from large university hospitals to smaller rural hospitals in eight countries from May 2010 to July 2017. 12-Lead ECG recordings were obtained at ED presentation following the syncopal event. The primary diagnostic outcome, a cardiac cause of syncope, was centrally adjudicated by two independent cardiologists using all available clinical information including 12-month follow-up. ECG predictors for a cardiac cause of syncope were identified using penalised backward selection and a continuous-scale likelihood was calculated based on regression analysis coefficients. Findings were validated in an independent US multicentre cohort including 2269 patients.RESULTS: In the derivation cohort, a cardiac cause of syncope was adjudicated in 267 patients (16%). Seven ECG criteria were identified as predictors for this outcome: heart rate and QTc-interval (continuous predictors), rhythm, atrioventricular block, ST-segment depression, bundle branch block and ventricular extrasystole/non-sustained ventricular tachycardia (categorical predictors). Diagnostic accuracy of these combined predictors for a cardiac cause of syncope was high (area under the curve 0.80, 95% CI 0.77 to 0.83). Overall, 138 patients (8%) were rapidly triaged towards rule-out and 181 patients (11%) towards rule-in of a cardiac cause of syncope. External validation showed similar performance.CONCLUSION: In patients ≥40 years with a syncopal event, a combination of seven ECG criteria enabled rapid assessment of the likelihood that syncope was due to a cardiac cause.TRIAL REGISTRATION NUMBER: NCT01548352 (BASEL IX), NCT01802398 (SRS study).

AB - OBJECTIVE: To develop an ECG-based tool for rapid risk assessment of a cardiac cause of syncope in patients ≥40 years.METHODS: In a prospective international multicentre study, 2007 patients ≥40 years presenting with syncope were recruited in the emergency department (ED) of participating centres ranging from large university hospitals to smaller rural hospitals in eight countries from May 2010 to July 2017. 12-Lead ECG recordings were obtained at ED presentation following the syncopal event. The primary diagnostic outcome, a cardiac cause of syncope, was centrally adjudicated by two independent cardiologists using all available clinical information including 12-month follow-up. ECG predictors for a cardiac cause of syncope were identified using penalised backward selection and a continuous-scale likelihood was calculated based on regression analysis coefficients. Findings were validated in an independent US multicentre cohort including 2269 patients.RESULTS: In the derivation cohort, a cardiac cause of syncope was adjudicated in 267 patients (16%). Seven ECG criteria were identified as predictors for this outcome: heart rate and QTc-interval (continuous predictors), rhythm, atrioventricular block, ST-segment depression, bundle branch block and ventricular extrasystole/non-sustained ventricular tachycardia (categorical predictors). Diagnostic accuracy of these combined predictors for a cardiac cause of syncope was high (area under the curve 0.80, 95% CI 0.77 to 0.83). Overall, 138 patients (8%) were rapidly triaged towards rule-out and 181 patients (11%) towards rule-in of a cardiac cause of syncope. External validation showed similar performance.CONCLUSION: In patients ≥40 years with a syncopal event, a combination of seven ECG criteria enabled rapid assessment of the likelihood that syncope was due to a cardiac cause.TRIAL REGISTRATION NUMBER: NCT01548352 (BASEL IX), NCT01802398 (SRS study).

U2 - 10.1136/heartjnl-2020-318430

DO - 10.1136/heartjnl-2020-318430

M3 - SCORING: Journal article

C2 - 33504514

VL - 107

SP - 1796

EP - 1804

JO - HEART

JF - HEART

SN - 1355-6037

IS - 22

ER -