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.

Implantable loop recorders in patients with Brugada syndrome: the BruLoop study / M. Bergonti, F. Sacher, E. Arbelo, L. Crotti, A. Sabbag, M. Casella, J. Saenen, A. Rossi, C. Monaco, L. Pannone, P. Compagnucci, V. Russo, E. Heller, A. Santoro, P. Berne, A. Bisignani, E. Baldi, O. Van Leuven, F. Migliore, L. Marcon, F. Dagradi, I. Sfondrini, F. Landra, A. Comune, M. Cespón-Fernández, M. Nesti, F. Santoro, M. Magnocavallo, A. Vicentini, S. Conti, V. Ribatti, P. Brugada, C. de Asmundis, J. Brugada, C. Tondo, P.J. Schwartz, M. Haissaguerre, A. Auricchio, G. Conte. - In: EUROPEAN HEART JOURNAL. - ISSN 0195-668X. - (2024), pp. ehae133.1-ehae133.11. [10.1093/eurheartj/ehae133]

Implantable loop recorders in patients with Brugada syndrome: the BruLoop study

M. Bergonti;L. Marcon;C. de Asmundis;C. Tondo;
2024

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.
Atrial arrhythmias; Brady-arrhythmias; Brugada syndrome; Loop recorder; Rhythm monitoring; Sudden cardiac death; Syncope; Ventricular arrhythmias
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
2024
6-mar-2024
Article (author)
File in questo prodotto:
File Dimensione Formato  
ehae133.pdf

accesso aperto

Descrizione: Clinical Research
Tipologia: Publisher's version/PDF
Dimensione 768.13 kB
Formato Adobe PDF
768.13 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1036808
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 2
  • ???jsp.display-item.citation.isi??? ND
social impact