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Is there a role for implantable loop recorders in risk stratification of perceived low risk Brugada syndrome patients?
Session:
Posters 5 - Écran 4 - Arritmologia
Speaker:
Dinis Mesquita
Congress:
CPC 2019
Topic:
C. Arrhythmias and Device Therapy
Theme:
04. Arrhythmias, General
Subtheme:
04.6 Arrhythmias, General – Clinical
Session Type:
Posters
FP Number:
---
Authors:
Dinis Valbom Mesquita; Leonor Parreira; Rita Marinheiro; Pedro Lopes Do Carmo; Pedro Campos Amador; Diogo Cavaco; Elisabete Vaz; José Maria Farinha; Francisco Bello Morgado; Francisco Moscoso Costa; Pedro Adragão
Abstract
<p><strong>Introduction</strong>: Brugada Syndrome (BS) is a heterogeneous channelopathy which predisposes patients to arrhythmic sudden death. Risk stratification of asymptomatic patients has changed over the years and current strategies are far from perfect, as numerous patients receiving ICDs never have ventricular arrhythmias and some aborted sudden death patients didn’t have criteria for ICD implant.</p> <p><strong>Objetives</strong>: We aim to understand the usefulness of implantable loop recorders (ILR) in BS patients perceived to be at low risk, in the refinement of risk stratification for sudden death.</p> <p><strong>Methods</strong>: ILR was implanted in low risk BS patients: asymptomatic with spontaneous type 1 ECG pattern and a negative electrophysiologic study (EPS) and asymptomatic with drug induced type 1 ECG pattern and a negative EPS. These were compared to a group of patients that had ICD implant according to IIb indication as stated in the current ventricular arrhythmias ESC guidelines of 2015. All patients had regular follow up with device interrogation for the identification of sustained and non-sustained ventricular arrhythmias (VA).</p> <p><strong>Results</strong>: A cohort of 16 patients had an ILR and 13 patients were implanted with an ICD (patients characteristics are displayed in table 1). In the ILR group, during mean follow up time of 12.8 (IQR 8.5-49.1) months, no patients had VA arrhythmias documented. In the ICD group, during follow up of 42.6 (IQR 8.6-65.3) months, 4 patients had non sustained VA (p=0.03 between groups) with 3 patients having appropriate ICD therapy for sustained VA (p=0.0140 between groups). The mean follow up time was significantly shorter in the ILR than in the ICD group (p=0.0011).</p> <p><strong>Conclusions</strong>: During follow up, patients with VA had a mean time to first appropriate ICD therapy of 49.8 months. Patients with sustained VA had previously non-sustained VA, thus continuous monitoring of patients with BS is useful for risk stratification.</p>
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