%0 Multicenter Study
%T Implantable loop recorders in patients with Brugada syndrome: the BruLoop study.
%A Bergonti M
%A Sacher F
%A Arbelo E
%A Crotti L
%A Sabbag A
%A Casella M
%A Saenen J
%A Rossi A
%A Monaco C
%A Pannone L
%A Compagnucci P
%A Russo V
%A Heller E
%A Santoro A
%A Berne P
%A Bisignani A
%A Baldi E
%A Van Leuven O
%A Migliore F
%A Marcon L
%A Dagradi F
%A Sfondrini I
%A Landra F
%A Comune A
%A Cespón-Fernández M
%A Nesti M
%A Santoro F
%A Magnocavallo M
%A Vicentini A
%A Conti S
%A Ribatti V
%A Brugada P
%A de Asmundis C
%A Brugada J
%A Tondo C
%A Schwartz PJ
%A Haissaguerre M
%A Auricchio A
%A Conte G
%J Eur Heart J
%V 45
%N 14
%D 2024 Apr 7
%M 38445836
%F 35.855
%R 10.1093/eurheartj/ehae133
%X <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.