Automated detection of Brugada-type electrocardiogram using diagnostic criteria of the European Society of Cardiology and the American Heart Association

The diagnostic criteria of Brugada syndrome were reported from the European Society of Cardiology (ESC) and the American Heart Association in 2002. We examined the automated detection of Brugada-type electrocardiogram (ECG) on 12-lead ECG analysis program by modifying ESC criteria and evaluated it. In ESC criteria, Brugada-type ECG was classified into 3 types of ST-segment abnormalities of V1 to V3 leads. We modified these criteria and determined automated detection criteria as follows: type 1: STj ≥ 0.2 mV and STj > ST1 > ST2 and T < 0 mV; type 2: STj ≥ 0.2 mV and STj > STmin ≥ 0.1 mV and T > 0 mV and T < 1.8 × R′ and S ≤ 3.0 mV; type 3: STj ≥ 0.2 mV and 0.1 mV > STmin > 0 mV and T > 0 mV and T < 1.8 × R′ and S ≥ 3.0 mV; STj, ST1, and ST2 are amplitude of the ST segment (STj: J point, ST1: J point +40 milliseconds, ST2: J point +80 milliseconds). We evaluated these criteria with 97 ECGs from 27 patients, which are diagnosed as Brugada syndrome in university hospital. Brugada-type ECGs were detected correctly in 85 of total 97 ECGs (sensitivity, 88.7%, type 1: 32/32, type 2: 50/61, type 3: 4/4). As compared with 5 cardiologists interpretation of Brugada-type ECGs, computer classified incorrectly in 20 ECGs (type 1: 2, type 2: 17, type 3: 1) in 21 524 cases.