Abstract

Background Experience with implantable loop recorders (ILR) in Brugada Syndrome (BrS) is limited. Objective We sought to evaluate the indications and yield of ILR monitoring in a single-centre BrS registry. Methods Demographic, clinical and follow-up data of BrS patients with ILR were collected. Results Of 415 BrS patients recruited consecutively, 50 (12%) received an ILR (58% males). Mean age at ILR implantation was 44±15 years. Thirty-one (62%) had experienced syncopal or pre-syncopal episodes, and 23 (46%) palpitations. During a median follow-up of 28 months (range 1-68), actionable events were detected in 11 subjects (22%); 7 had recurrences of syncope/presyncope, and in 4 defects in sinus node function or atrioventricular conduction were detected. New supraventricular tachyarrhythmias were recorded in 6 subjects; a run of fast non-sustained VT was detected in one patient. Patients implanted with an ILR were less likely to show a spontaneous type 1 pattern or depolarisation ECG abnormalities compared to those receiving a primary prevention ICD. Age at implantation, gender, Shanghai score and ECG parameters did not differ between subjects with actionable events and those without. Device-related complications occurred in 3 cases (6%). Conclusion In a large cohort of BrS patients, continuous ILR monitoring yielded a diagnosis of tachy- or brady-arrhythmic episodes in 22% of cases. Recurrences of syncope were associated with brady-arrhythmic events. The use of ILR can be helpful in guiding the management of low/intermediate risk BrS patients and ascertaining the cause of unexplained syncope.