Implantable Loop Recorder Monitoring for Refining Management of Children With Inherited Arrhythmia Syndromes

Autor: Burt I. Bromberg, Jennifer N. Avari Silva, Fredrick K. Emge, Tammy M. Bowman, George F. Van Hare
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Male
medicine.medical_specialty
Pediatrics
Adolescent
Long QT syndrome
Population
Monitoring
Ambulatory
030204 cardiovascular system & hematology
Arrhythmias
Catecholaminergic polymorphic ventricular tachycardia
Sudden Cardiac Death
Right ventricular cardiomyopathy
03 medical and health sciences
0302 clinical medicine
channelopathy
Internal medicine
Pediatric Cardiology
Implantable loop recorder
Medicine
Humans
education
Child
Brugada syndrome
Original Research
Retrospective Studies
education.field_of_study
implantable loop recorder
business.industry
Retrospective cohort study
Arrhythmias
Cardiac
Prostheses and Implants
medicine.disease
pediatric
Death
Sudden
Cardiac
Treatment Outcome
inherited arrhythmia syndrome
Child
Preschool
Cohort
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
030217 neurology & neurosurgery
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
ISSN: 2047-9980
Popis: Background Implantable loop recorders (ILRs) are conventionally utilized to elucidate the mechanism of atypical syncope. The objective of this study was to assess the impact of these devices on management of pediatric patients with known or suspected inherited arrhythmia syndromes. Methods and Results A retrospective chart review was undertaken of all pediatric patients with known or suspected inherited arrhythmia syndromes in whom an ILR was implanted from 2008 to 2015. Captured data included categorization of diagnosis, treatment, transmitted tracings, and the impact of ILR tracings on management. Transmissions were categorized as symptomatic, autotriggered, or routine. Actionable transmissions were abnormal tracings that directly resulted in a change of medical or device therapy. A total of 20 patients met the stated inclusion criteria (long QT syndrome, n=8, catecholaminergic polymorphic ventricular tachycardia,n=9, Brugada syndrome, n=1, arrhythmogenic right ventricular cardiomyopathy, n=2), with 60% of patients being genotype positive. Primary indication for implantation of ILR included ongoing monitoring +/− symptoms (n=15, 75%), suspicion of noncompliance (n=1, 5%), and liberalization of recommended activity restrictions (n=4, 25%). A total of 172 transmissions were received in patients with inherited arrhythmia syndromes, with 7% yielding actionable data. The majority (52%) of symptom events were documented in the long QT syndrome population, with only 1 tracing (5%) yielding actionable data. Automatic transmissions were mostly seen in the catecholaminergic polymorphic ventricular tachycardia cohort (81%), with 21% yielding actionable data. There was no actionable data in routine transmissions. Conclusions ILRs in patients with suspected or confirmed inherited arrhythmia syndromes may be useful for guiding management. Findings escalated therapies in 30% of subjects. As importantly, in this high‐risk population, the majority of symptom events represented normal or benign rhythms, reassuring patients and physicians that no further intervention was required.
Databáze: OpenAIRE
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