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Implantable loop recorders in patients with Brugada syndrome: the BruLoop study
Journal article   Peer reviewed

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

Marco Bergonti, Frederic Sacher, Elena Arbelo, Lia Crotti, Avi Sabbag, Michela Casella, Johan Saenen, Andrea Rossi, Cinzia Monaco, Luigi Pannone, …
European heart journal, Vol.45(14), pp.1255-1265
04/07/2024
DOI: 10.1093/eurheartj/ehae133
PMCID: PMC10998731
PMID: 38445836

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Abstract

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. 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. 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. 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.
 Adult Arrhythmias, Cardiac - complications Arrhythmias, Cardiac - diagnosis Brugada Syndrome - complications Brugada Syndrome - diagnosis Brugada Syndrome - therapy Defibrillators, Implantable Electrocardiography - methods Electrocardiography, Ambulatory - methods Female Humans Male Middle Aged Pacemaker, Artificial

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