Continuous Rhythm Monitoring With Implanted Loop Recorders in Children and Adolescents With Brugada Syndrome
Por:
Bergonti M, Ciconte G, Cruzalegui JC, Crotti L, Arbelo E, Casella M, Saenen J, Rossi A, Pannone L, Martínez-Barrios E, Compagnucci P, Russo V, Berne P, Van Leuven O, Boccellino A, Marcon L, Dagradi F, Landra F, Özkartal T, Comune A, Conti S, Ribatti V, Campuzano O, Brugada P, de Asmundis C, Brugada J, Pappone C, Tondo C, Schwartz PJ, Auricchio A, Sarquella-Brugada G and Conte G
Publicada:
3 sep 2024
Ahead of Print:
1 ago 2024
Resumen:
BACKGROUND Young (<18 years of age) patients with Brugada syndrome (BrS)
are often under-represented in BrS studies and their management,
especially related to syncopal episodes, remains unclear. OBJECTIVES
This study sought to describe the arrhythmia prevalence among young
patients with BrS undergoing continuous rhythm monitoring by implantable
loop recorder (ILR) and to assess the etiology behind syncope of
undetermined origin. METHODS A total of 147 patients with BrS with ILR
were enrolled in 12 international centers and divided into pediatric
(age <12 years; n = 77, 52%) and adolescents (age 13-18 years; n = 70,
48%). RESULTS Mean age was 11.3 years, 53 patients (36.1%) were female,
and 31 (21.1%) had spontaneous type 1 electrocardiograms. Over a median
follow-up of 3.6 years (Q1-Q3: 1.6-4.8 years), an arrhythmic event was
recorded in 33 patients (22.4%), mainly of nonventricular origin: 15
atrial (10.2%) and 16 bradyarrhythmic events (10.9%). Ventricular
arrhythmias occurred in 4 patients, all with spontaneous BrS, and were
fever-related in one-half. Among all patients with recurrence of syncope
during follow-up, true arrhythmic syncope was documented in 5 (17.8%),
and it was due to bradyarrhythmias or atrial arrhythmias in 3 cases
(60%). CONCLUSIONS Continuous rhythm monitoring with ILRs in young
patients with BrS detects a broad range of arrhythmias. Ventricular
arrhythmias occur predominantly in patients with spontaneous type 1
electrocardiograms and during fever. Despite the young age,
bradyarrhythmias and atrial arrhythmias are frequent and represent the
cause of arrhythmic syncope in 60% of patients. Young patients with BrS
with syncope of undetermined origin may benefit from ILR implant. (c)
2024 The Authors. Published by Elsevier on behalf of the American
College of Cardiology Foundation. This is an open access article under
the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
Filiaciones:
Bergonti M:
Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
Ciconte G:
Arrhythmology Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, Milan, Italy
School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
Cruzalegui JC:
Pediatric Arrhythmias, Inherited Cardiac Diseases and Sudden Death Unit, Hospital Sant Joan de Déu, Universitat de Barcelona. Barcelona, Spain
Arrítmies Pediàtriques, Cardiologia Genètica i Mort Sobtada, Malalties Cardiovasculars en el Desenvolupament, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
Crotti L:
Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Istituto Auxologico Italiano, IRCCS, Milan, Italy
Department of Medicine and Surgery, University Milano Bicocca, Milan, Italy
Arbelo E:
Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
Casella M:
Cardiology and Arrhythmology Clinic, University Hospital "Ospedali Riuniti," Ancona, Italy
Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy
Saenen J:
Department of Cardiology, University Hospital Antwerp, Edegem, Belgium
Rossi A:
Arrhythmology Division, Fondazione Gabriele Monasterio Consiglio Nazionale delle Richerche-Regione Toscana, Pisa, Italy
Pannone L:
Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium
Martínez-Barrios E:
Pediatric Arrhythmias, Inherited Cardiac Diseases and Sudden Death Unit, Hospital Sant Joan de Déu, Universitat de Barcelona. Barcelona, Spain
Arrítmies Pediàtriques, Cardiologia Genètica i Mort Sobtada, Malalties Cardiovasculars en el Desenvolupament, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
Compagnucci P:
Cardiology and Arrhythmology Clinic, University Hospital "Ospedali Riuniti," Ancona, Italy
Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy
Russo V:
Cardiology Unit, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli," Monaldi Hospital, Naples, Italy
Berne P:
Department of Cardiology, Ospedale Santissima Annunziata, University of Sassari, Sassari, Italy
Van Leuven O:
Department of Cardiology, University Hospital Antwerp, Edegem, Belgium
Boccellino A:
Arrhythmology Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, Milan, Italy
School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
Marcon L:
Department of Clinical Electrophysiology and Cardiac Pacing, Centro Cardiologico Monzino IRCCS, Milan, Italy
Department of Biomedical, Surgery and Dentist Sciences, University of Milan, Milan, Italy
Dagradi F:
Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Istituto Auxologico Italiano, IRCCS, Milan, Italy
Landra F:
Arrhythmology Division, Fondazione Gabriele Monasterio Consiglio Nazionale delle Richerche-Regione Toscana, Pisa, Italy
Özkartal T:
Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
Comune A:
Cardiology Unit, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli," Monaldi Hospital, Naples, Italy
Conti S:
Department of Cardiac Electrophysiology, Azienda di Rilievo Nazionale ed Alta Specializzazione Ospedali Civico Di Cristina Benfratelli, Palermo, Italy
Ribatti V:
Department of Clinical Electrophysiology and Cardiac Pacing, Centro Cardiologico Monzino IRCCS, Milan, Italy
Department of Biomedical, Surgery and Dentist Sciences, University of Milan, Milan, Italy
Campuzano O:
Department of Medical Sciences, Faculty of Medicine, Universitat de Girona, Girona, Spain
Brugada P:
Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium
de Asmundis C:
Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium
Brugada J:
Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
Pappone C:
Arrhythmology Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, Milan, Italy
School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
Tondo C:
Department of Clinical Electrophysiology and Cardiac Pacing, Centro Cardiologico Monzino IRCCS, Milan, Italy
Department of Biomedical, Surgery and Dentist Sciences, University of Milan, Milan, Italy
Schwartz PJ:
Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Istituto Auxologico Italiano, IRCCS, Milan, Italy
Auricchio A:
Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
Sarquella-Brugada G:
Pediatric Arrhythmias, Inherited Cardiac Diseases and Sudden Death Unit, Hospital Sant Joan de Déu, Universitat de Barcelona. Barcelona, Spain
Arrítmies Pediàtriques, Cardiologia Genètica i Mort Sobtada, Malalties Cardiovasculars en el Desenvolupament, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
Department of Pediatrics, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
Medical Sciences Department, School of Medicine, University of Girona, Girona, Spain
Conte G:
Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
Green Submitted, hybrid
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