Rattanawong et al reported the Predicting Arrhythmia Event (PAT) score for predicting the risk of a first major arrhythmic event. The authors are from multiple institutions in the United States and Thailand.
Patient selection: Brugada syndrome
Outcome: major arrhythmic event (MAE): sudden cardiac arrest, sudden cardiac death, sustained ventricular tachycardia or fibrillation, appropriate ICD therapy
Parameters:
(1) major arrhythmic event during drug challenge testing
(2) T-peak to T-end in ms
(3) PR in ms
(4) fragmented QRS
(5) type 1 in peripheral leads
(6) aVR sign
(7) early repolarization in inferolateral leads
(8) history of arrhythmic syncope
(9) history of unexplained syncope
|
Parameter
|
Finding
|
Points
|
|
major arrhythmic event during drug challenge
|
no
|
0
|
|
|
yes
|
4
|
|
T-peak to T-end
|
< 100 ms
|
0
|
|
|
>= 100 ms
|
5
|
|
PR intervale
|
< 200 ms
|
0
|
|
|
>= 200 ms
|
4
|
|
fragmented QRS
|
no
|
0
|
|
|
yes
|
3
|
|
type 1 in peripheral leads
|
no
|
0
|
|
|
yes
|
3
|
|
aVR sign
|
no
|
0
|
|
|
yes
|
3
|
|
early repolarization inferolateral leads
|
no
|
0
|
|
|
yes
|
3
|
|
history of arrhythmic syncope
|
no
|
0
|
|
|
yes
|
5
|
|
history of unexplained syncope
|
no
|
0
|
|
|
yes
|
5
|
total score for the 9 high impact factors =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 35 (with both syncope histories allowed)
• A score >= 10 identifies a patient at high risk for major arrhythmic event.
Performance:
• The area under the ROC curve for first MAE was 0.95.
• The area under the ROC curve for recurrent MAE was 0.71.
