Key result
ILRs in Brugada syndrome primarily record supraventricular arrhythmias and conduction disorders, rarely detecting ventricular arrhythmias.
Why the study?
The role of implantable loop recorders in inherited arrhythmic conditions such as Brugada syndrome remains a topic of debate.
Does continuous ECG monitoring through implantable loop recorder improve arrhythmia detection and symptom-to-rhythm correlation in patients with Brugada syndrome?
Does continuous ECG monitoring through implantable loop recorder improve arrhythmia detection and symptom-to-rhythm correlation in patients with Brugada syndrome?
ILRs in Brugada syndrome patients are useful for symptom-to-rhythm correlation, primarily detecting supraventricular arrhythmias and conduction disorders, though their value in asymptomatic patients requires further evaluation.
ILRs aid symptom-rhythm correlation in symptomatic Brugada syndrome; leaves open utility in asymptomatic patients.
Brugada syndrome (BrS) is a genetic condition that increases the risk of life-threatening arrhythmias, which can result in sudden cardiac death (SCD). Implantable loop recorders (ILRs) have become a key tool in managing patients with unexplained syncope, and guidelines advise their use in individuals with recurrent, unexplained syncope or palpitations. However, the role of ILRs in inherited arrhythmic conditions like BrS remains a topic of debate. Most patients newly diagnosed with BrS show no symptoms, but around 30% may experience symptoms such as syncope or palpitations, which can arise from arrhythmic issues or other causes like neurally mediated reflexes. Accurately assessing the cause of these symptoms is crucial to evaluate the risk of SCD. This document aims to examine current evidence on the role of ILR implantation in patients with BrS. The most frequent arrhythmias recorded by ILR are supraventricular arrhythmias and conduction disorders; ventricular arrhythmias, usually nonsustained, are rarely recorded. Symptoms-to-rhythm correlation by ILR can have therapeutic implications in case of recorded arrhythmias (initiation of drug therapy, ablation procedures or defibrillator/pace-maker implantation), provide reassurance in patients without rhythm disorders documented and improve their quality of life. However, given the low rate of detected arrhythmias, the clinical value of ILR in asymptomatic patients needs further evaluation.
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Calvelli et al. (2024) conducted a review in Brugada syndrome. Implantable loop recorder (ILR) was evaluated. Implantable loop recorders in Brugada syndrome patients most frequently record supraventricular arrhythmias and conduction disorders, while ventricular arrhythmias are rarely recorded.
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