%0 Journal Article
%T Arrhythmia detection using an implantable loop recorder after a negative electrophysiology study in Brugada syndrome: Observations from a multicenter international registry.
%A García-Izquierdo E
%A Scrocco C
%A Palacios-Rubio J
%A Assaf A
%A Ripoll-Vera T
%A Hernandez-Betancor I
%A Ramos-Ruiz P
%A Melero-Pita A
%A Segura-Domínguez M
%A Jiménez-Sánchez D
%A Castro-Urda V
%A Toquero-Ramos J
%A Yap SC
%A Behr ER
%A Fernández-Lozano I
%J Heart Rhythm
%V 21
%N 8
%D 2024 Aug 7
%M 38458509
%F 6.779
%R 10.1016/j.hrthm.2024.03.003
%X <B>BACKGROUND: </B>Risk stratification in Brugada syndrome (BrS) remains controversial. In this respect, the role of the electrophysiology study (EPS) has been a subject of debate. In some centers, it is common practice to use an implantable loop recorder (ILR) after a negative EPS to help in risk stratification. However, the diagnostic value of this approach has never been specifically addressed.<BR><B>OBJECTIVE: </B>The aim of this study was to describe the baseline characteristics and the main findings of a diagnostic workup strategy with an ILR after a negative EPS in BrS.<BR><B>METHODS: </B>We conducted a retrospective international registry including patients with BrS and negative EPS (ie, noninducible ventricular tachycardia or ventricular fibrillation) before ILR monitoring.<BR><B>RESULTS: </B>The study included 65 patients from 8 referral hospitals in The Netherlands, Spain, and the United Kingdom (mean age, 39 ± 16 years; 72% male). The main indication for ILR monitoring was unexplained syncope/presyncope (66.2%). During a median follow-up of 39.0 months (Q1 25.0-Q3 47.6 months), 18 patients (27.7%) experienced 21 arrhythmic events (AEs). None of the patients died during follow-up. Bradyarrhythmias were the most common finding (47.6%), followed by atrial tachyarrhythmias (38.1%). Only 3 patients presented with ventricular arrhythmias. AEs were considered incidental in 12 patients (66.7%). In 11 patients (61.1%), AEs led to specific changes in treatment.<BR><B>CONCLUSIONS: </B>The use of ILR after a negative EPS in BrS is a safe strategy that reflected the high negative predictive value of EPS for ventricular arrhythmia in this syndrome. In addition, it allowed the detection of AEs in a significant proportion of patients, with therapeutic implications in most of them.