SPC365

Implantable Loop Recorder Monitoring in Cardiomyopathies: Unveiling Clinically Relevant Arrhythmias

Session: Sessão de Posters 03 - Arritmias cardíacas e dispositivos percutâneos no risco cardioembólico
Speaker: MARIANA GOMES TINOCO

Congress: CPC 2024
Topic: C. Arrhythmias and Device Therapy
Theme: 09. Device Therapy
Subtheme: 09.6 Device Therapy - Other
Session Type: Cartazes
FP Number: ---
Authors: Mariana Tinoco; Margarida Castro; Luísa Pinheiro; Lucy Calvo; Olga Azevedo; Filipa Almeida; Silvia Ribeiro; Filipa Cardoso; Bernardete Rodrigues; Rita Andrade; Victor Sanfins; António Lourenço

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Comic Sans MS,cursive"><span style="background-color:white"><strong><span style="background-color:white"><span style="color:black">Background:</span></span></strong><span style="background-color:white"><span style="color:black"> Implantable loop recorders (ILR) are a valuable tool in the diagnosis of infrequent arrhythmias in cardiomyopathy patients (CM P). Their impact on improving the detection of relevant arrhythmias and guiding clinical management is still being studied.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Comic Sans MS,cursive"><span style="background-color:white"><strong><span style="background-color:white"><span style="color:black">Purpose:</span></span></strong><span style="background-color:white"><span style="color:black"> To evaluate the value of ILR on the diagnosis of dysrhythmias and subsequent management of CM P and arrhythmia suggestive symptoms.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Comic Sans MS,cursive"><span style="background-color:white"><strong><span style="background-color:white"><span style="color:black">Methods:</span></span></strong><span style="background-color:white"><span style="color:black"> Single-center retrospective study that included CM P who underwent ILR implantation due to arrhythmia suggestive symptoms.</span></span></span></span></span></p>

<p style="text-align:justify"><br />
<span style="font-size:12px"><span style="font-family:Comic Sans MS,cursive"><span style="background-color:white"><span style="color:black"><strong><span style="background-color:white">Results:</span></strong><span style="background-color:white"> This study included 44P (52% females; mean age 59&plusmn;17 years) with the following CM: 43.5% (19P) dilated CM (DCM), 34% (15P) hypertrophic CM (HCM), 9% (4P) RV arrhythmogenic CM (ACM), 4.5% (2P) non-dilated LV CM with hypertrabeculation </span></span><span style="background-color:white"><span style="color:black">(N-DCH), 4.5% (2P) Fabry disease (FD) and 4.5% (2P) transthyretin amyloidosis (ATTR). None of the P had experienced life-threatening arrhythmias prior to ILR implantation. </span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Comic Sans MS,cursive"><span style="background-color:white"><span style="background-color:white"><span style="color:black">The most common reasons for ILR implantation were unexplained syncope (71%) and palpitations suspected to be of arrhythmic origin (23%).</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Comic Sans MS,cursive"><span style="background-color:white"><span style="background-color:white"><span style="color:black">During a median follow-up of 18 (IQR 5-34) months after ILR implantation, arrhythmic events were documented in 27P (61%). Specifically, sustained ventricular tachycardia (VT) was detected in 8P (2 DCM, 2 HCM, 1 ACM, 1 N-DCH, 1 FD, 1 ATTR), and non-sustained VT in 1P (ACM). As a result, all of those P underwent ICD implantation.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Comic Sans MS,cursive"><span style="background-color:white"><span style="background-color:white"><span style="color:black">3P with HCM had symptomatic pauses&gt;6s due to sick sinus syndrome, resulting in 1 beta-blocker dose reduction, 1 pacemaker implantation and 1 ICD (P also had non-sustained VT). 4P had complete heart block leading to: 2 CRT-D (HCM and DCM, P with borderline LVEF~35%), 1 ICD (FD, P also had non-sustained VT) and 1 pacemaker implantation (HCM).</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Comic Sans MS,cursive"><span style="background-color:white"><span style="background-color:white"><span style="color:black">One HCM P had slow atrial fibrillation (AF), resulting in pacemaker implantation. Six P had AF, with 3 experiencing symptoms, all started anticoagulation. Two P had asymptomatic supraventricular tachycardia. One patient with DCM had wide complex tachycardia and underwent an electrophysiological study with ventricular programmed stimulation, which was negative. One DCM P had nocturnal heart block with subsequent sleep apnea diagnosis and started CPAP therapy. Symptoms without diagnostic findings were reported in 2P.</span></span></span></span></span></p>

<p style="text-align:justify"><br />
<span style="font-size:12px"><span style="font-family:Comic Sans MS,cursive"><span style="background-color:white"><span style="color:black"><strong><span style="background-color:white">Conclusions</span></strong><span style="background-color:white">: ILR monitoring identified clinically relevant arrhythmias in over half of the CM P and arrhythmia suggestive symptoms, leading in most of them to a management change with a potential prognostic impact on sudden death and thromboembolism prevention, such as device implantation and anticoagulation. </span></span></span></span></span></p>