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- Title
Implantable loop recorders in patients with Brugada syndrome: the BruLoop study.
- Authors
Bergonti, Marco; Sacher, Frederic; Arbelo, Elena; Crotti, Lia; Sabbag, Avi; Casella, Michela; Saenen, Johan; Rossi, Andrea; Monaco, Cinzia; Pannone, Luigi; Compagnucci, Paolo; Russo, Vincenzo; Heller, Eyal; Santoro, Amato; Berne, Paola; Bisignani, Antonio; Baldi, Enrico; Leuven, Olivier Van; Migliore, Federico; Marcon, Lorenzo
- Abstract
Background and Aims Available data on continuous rhythm monitoring by implantable loop recorders (ILRs) in patients with Brugada syndrome (BrS) are scarce. The aim of this multi-centre study was to evaluate the diagnostic yield and clinical implication of a continuous rhythm monitoring strategy by ILRs in a large cohort of BrS patients and to assess the precise arrhythmic cause of syncopal episodes. Methods A total of 370 patients with BrS and ILRs (mean age 43.5 ± 15.9, 33.8% female, 74.1% symptomatic) from 18 international centers were included. Patients were followed with continuous rhythm monitoring for a median follow-up of 3 years. Results During follow-up, an arrhythmic event was recorded in 30.7% of symptomatic patients [18.6% atrial arrhythmias (AAs), 10.2% bradyarrhythmias (BAs), and 7.3% ventricular arrhythmias (VAs)]. In patients with recurrent syncope, the aetiology was arrhythmic in 22.4% (59.3% BAs, 25.0% VAs, and 15.6% AAs). The ILR led to drug therapy initiation in 11.4%, ablation procedure in 10.9%, implantation of a pacemaker in 2.5%, and a cardioverter-defibrillator in 8%. At multivariate analysis, the presence of symptoms [hazard ratio (HR) 2.5, P =.001] and age >50 years (HR 1.7, P =.016) were independent predictors of arrhythmic events, while inducibility of ventricular fibrillation at the electrophysiological study (HR 9.0, P <.001) was a predictor of VAs. Conclusions ILR detects arrhythmic events in nearly 30% of symptomatic BrS patients, leading to appropriate therapy in 70% of them. The most commonly detected arrhythmias are AAs and BAs, while VAs are detected only in 7% of cases. Symptom status can be used to guide ILR implantation.
- Subjects
BRUGADA syndrome; SYNCOPE; ATRIAL arrhythmias; ARRHYTHMIA; VENTRICULAR arrhythmia; VENTRICULAR fibrillation
- Publication
European Heart Journal, 2024, Vol 45, Issue 14, p1255
- ISSN
0195-668X
- Publication type
Article
- DOI
10.1093/eurheartj/ehae133