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Which Brugada patient deserves continuous ECG monitoring through implantable loop recorder? An evidence update.

J Cardiovasc Med (Hagerstown)

February 2025

Division of Cardiology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende (CS).

Brugada syndrome (BrS) is a genetic condition that increases the risk of life-threatening arrhythmias, which can result in sudden cardiac death (SCD). Implantable loop recorders (ILRs) have become a key tool in managing patients with unexplained syncope, and guidelines advise their use in individuals with recurrent, unexplained syncope or palpitations. However, the role of ILRs in inherited arrhythmic conditions like BrS remains a topic of debate.

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Objective: To conceptualise the cognitive processes of early expert decision-making in urgent care.

Background: Expert clinicians in the UK frequently determine suitable urgent care patient pathways via telephone triage. This strategy is promoted by policymakers but how it is performed, and its effectiveness has not been evaluated.

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Background: Remote symptom monitoring (RSM) is an evidence-based strategy shown to mitigate postoperative morbidity; however, platform engagement is required to benefit from RSM. Patients who report current smoking are at high risk for postoperative complications, but it is unknown whether smoking status influences engagement with RSM, symptom severity, or unanticipated acute care visits.

Methods: This observational case-control study was conducted in patients undergoing ambulatory oncologic surgery at a large cancer center.

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Background: Hypotensive episodes detected by 24-hour ambulatory blood pressure (BP) monitoring capture daily cumulative hypotensive stress and could be clinically relevant to cognitive impairment, but this relationship remains unclear.

Methods: We included participants from the Systolic Blood Pressure Intervention Trial (receiving intensive or standard BP treatment) who had 24-hour ambulatory BP monitoring measured near the 27-month visit and subsequent biannual cognitive assessments. We evaluated the associations of hypotensive episodes (defined as systolic BP drops of ≥20 mm Hg between 2 consecutive measurements that reached <100 mm Hg) and hypotensive duration (cumulative time of systolic BP <100 mm Hg) with subsequent cognitive function using adjusted linear mixed models.

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Background: Iatrogenic pneumothorax is a common complication of diagnostic and therapeutic pulmonary procedures. New guidelines on primary spontaneous pneumothorax suggest ambulatory approaches may be suitable. However, guidance on iatrogenic pneumothorax occurring in patients with impaired lung function, increased age, comorbidity and frailty is lacking, and the safety profile of ambulatory management is not known.

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