Innovative approaches to Brugada syndrome management: extending follow-up protocols with loop recorder technology

Brugada sindrome is a genetic disorder charcterized by an inherited channelopathy that predisposes to cardiac arrhytmisad and sudden cardiac death; it stands as the primary cause of death in individuals under 40 years old, excluding road accidents. It is diagnosed in asymptomatic patients through an electrophysiological examination on the ECG with the administration of sodium channel blockers. The results of risk stratification include the implantation of a cardiac defibrillator or a series of follow-ups for intermediate cases. For the latter, more durable monitoring techniques or devices are sought, as ECG changes are not always consistently present in the same patient, using for example a Loop Recorder. In this thesis, an analysis was conducted on a population of 25 affected patients who tested positive with ajmaline; The ST segments of an ECG lead (V2 or V4), obtained with two electrodes connected to the BIOMONITOR programmer, and of the loop recorder were examined. Specifically, the study aimed to determine the correlation strength between the two signals and the amplitude difference of their respective J points. The implementation of the algorithm will be described, and the results will be analyzed to outline the advantages of employing the loop recorder in these specific contexts.