916 the Smartwatch Detects Ecg Abnormalities Typical of Brugada Syndrome

Abstract

Introduction Brugada syndrome (BrS) is a genetic disorder with a characteristic pattern on the electrocardiogram (ECG) that predisposes to lethal arrhythmias and sudden cardiac death (SCD). Precise diagnosis is therefore mandatory. Aims We evaluated the feasibility and accuracy of a smartwatch in recording multiple ECG leads and detecting ST-segment changes diagnostic for BrS both in basal condition and after ajmaline infusion. Materials and Methods Twelve-leads and smartwatch ECGs were obtained in 32 unselected patients admitted at our institution with type II/III ST-segment elevation suspected for BrS from September 2021 to March 2022. After written informed consent for continuous ECG monitoring during ajmaline test (1 mg/kg, i.v. for 10 min), consecutive ECG strips acquired with both techniques were analyzed before and after drug administration. For each patient smartwatch was tested at three different sites: wrist, abdomen and chest, and intercostal spaces from second to fourth were further studied. The concordance among the results of the smartwatch and standard ECG recordings was assessed using the Cohen κ coefficient and Bland-Altman analysis. Results Subjects were 42±15 y.o. on average; 67% were men (n=25), and diagnosis of BrS was reached in 12 cases (37.5%). Concordance was found between the smartwatch and standard ECG for the identification of the following findings: i) a normal/negative ECG (Cohen κ coefficient, 0.89); ii) ST-segment elevation shift (Cohen κ coefficient, 0.934). In addition, the Bland-Altman analysis demonstrated concordance between the smartwatch and the standard ECG in the assessment of the amplitude of ST-segment elevation shift (bias, −0.003; SD, 0.68; lower limit, −0.52; and upper limit, -0.031). The smartwatch power in diagnosing normal ECG showed a sensitivity of 92% (95% CI, 66%-99%) and a specificity of 100% (95% CI, 64%-100%); for detection of ST-segment elevation and BrS diagnosis, sensitivity was 92% (95% CI, 64%-99%) and specificity was 95% (95% CI, 76%-99%). Conclusions The findings of this study suggest agreement between the multichannel smartwatch acquisition and standard ECG for the identification of Brugada syndrome-associated ST-segment changes.