{Reference Type}: Multicenter Study
{Title}: Implantable loop recorders in patients with Brugada syndrome: the BruLoop study.
{Author}: Bergonti M;Sacher F;Arbelo E;Crotti L;Sabbag A;Casella M;Saenen J;Rossi A;Monaco C;Pannone L;Compagnucci P;Russo V;Heller E;Santoro A;Berne P;Bisignani A;Baldi E;Van Leuven O;Migliore F;Marcon L;Dagradi F;Sfondrini I;Landra F;Comune A;Cespón-Fernández M;Nesti M;Santoro F;Magnocavallo M;Vicentini A;Conti S;Ribatti V;Brugada P;de Asmundis C;Brugada J;Tondo C;Schwartz PJ;Haissaguerre M;Auricchio A;Conte G;
{Journal}: Eur Heart J
{Volume}: 45
{Issue}: 14
{Year}: 2024 Apr 7
{Factor}: 35.855
{DOI}: 10.1093/eurheartj/ehae133
{Abstract}: <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.