950 THE ROLE OF THE BETA ANGLE IN THE MANAGEMENT OF PATIENTS WITH SUSPECTED BRUGADA SYNDROME: A METANALYSIS. (15th December 2022) - Vetta, Giampaolo
Abstract: Background: The diagnostic value of the β-angle in the diagnosis of patients with Brugada Syndrome (BrS) is still unclear. Objective: to evaluate the diagnostic accuracy of the β-angle and establish its best cut-off value. Methods: We searched databases for studies evaluating sensitivity and specificity of the β-angle in patients with suspected BrS undergoing Sodium Channel Blocker Provocation Test (SCBPT). The pooled sensitivity and specificity were calculated, and the Summary Receiver Operating Characteristic curve was constructed. The effect size was estimated using a random-effect model as Odds Ratio. Results: we included 4 studies enrolling 1471 patients (Positive SCBPT: 382 patients; Negative SCBPT: 1089 patients). Patients with positive SCBPT had a higher mean β-angle value than those with negative SCBPT (39.25° vs 22.52°; p<0.0001). The best diagnostic accuracy was observed at the IV Intercostal space (Ic) (AUC: 0.82; 95% CI: 0.78-0.85) compared to IIIic (AUC:0.77; 95% CI: 0.74–0.81) and IIic (AUC: 0.68; 95% CI: 0.64–0.72), Figure 1. The risk of positive SCBPT was significantly increased in patients with a β-angle≥58° than those with a β-angle≥23° (OR:16.33 vs 3.39; p=0.0004). Conclusion: A β-angle ≥58° represents the best diagnostic predictor for patients with suspected BrS. Figure 1. Summary Receiver Operating Characteristic curves and Areas Under The Curve of β-angle in all Ic spaces (A), IVic (B), IIIic (C) and IIic (D).