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Advances in cardiac implantable electronic devices (CIEDs) have prolonged life expectancy in various medical settings. However, the issue of hypersensitivity to components of CIEDs is still a concern. Since 1970, allergic reactions to metallic and nonmetallic components of CIEDs have been reported. Hypersensitivity reactions to medical devices are rare and not fully understood. In some cases, diagnosis and treatment are difficult. Cardiologists should always keep in mind pacemaker allergy when a patient appears with wound complications and no signs of infection. Patch testing should be tailored toward the specific biomaterials used in a device, in addition to testing with standard screening allergens in select cases. [ABSTRACT FROM AUTHOR]

Introduction: Brugada syndrome (BrS) has a dynamic ECG pattern that might be revealed by certain conditions such as fever. We evaluated the incidence and management of ventricular arrhythmias (VAs) related to COVID‐19 infection and vaccination among BrS patients carriers of an implantable loop recorder (ILR) or implantable cardioverter‐defibrillator (ICD) and followed by remote monitoring. Methods: This was a multicenter retrospective study. Patients were carriers of devices with remote monitoring follow‐up. We recorded VAs 6 months before COVID‐19 infection or vaccination, during infection, at each vaccination, and up to 6‐month post‐COVID‐19 or 1 month after the last vaccination. In ICD carriers, we documented any device intervention. Results: We included 326 patients, 202 with an ICD and 124 with an ILR. One hundred and nine patients (33.4%) had COVID‐19, 55% of whom developed fever. Hospitalization rate due to COVID‐19 infection was 2.76%. After infection, we recorded only two ventricular tachycardias (VTs). After the first, second, and third vaccines, the incidence of non‐sustained ventricular tachycardia (NSVT) was 1.5%, 2%, and 1%, respectively. The incidence of VT was 1% after the second dose. Six‐month post‐COVID‐19 healing or 1 month after the last vaccine, we documented NSVT in 3.4%, VT in 0.5%, and ventricular fibrillation in 0.5% of patients. Overall, one patient received anti‐tachycardia pacing and one a shock. ILR carriers had no VAs. No differences were found in VT before and after infection and before and after each vaccination. Conclusions: From this large multicenter study conducted in BrS patients, followed by remote monitoring, the overall incidence of sustained VAs after COVID‐19 infection and vaccination is relatively low. [ABSTRACT FROM AUTHOR]