Implantable loop recorders in patients with Brugada syndrome: the BruLoop study.
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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, Van Leuven Olivier, Migliore Federico, Marcon Lorenzo, Dagradi Federica, Sfondrini Irene, Landra Federico, Comune Angelo, Cespón-Fernández María, Nesti Martina, Santoro Francesco, Magnocavallo Michele, Vicentini Alessandro, Conti Sergio, Ribatti Valentina, Brugada Pedro, de Asmundis Carlo, Brugada Josep, Tondo Claudio, Schwartz Peter J, Haissaguerre Michel, Auricchio Angelo, Conte Giulio
Аннотация
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.