A Retrospective Case Study to Assess the Value of the Implantable Loop Recorder for the Investigation of Undiagnosed Syncope.

Autor: Ashby, Dale T., Cehic, Daniel A., Disney, Patrick J. S., Mahar, Leo J., Young, Glenn D.
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Zdroj: Pacing & Clinical Electrophysiology; Aug2002, Vol. 25 Issue 8, p1200-1205, 6p
Abstrakt: If not diagnosed by history, examination, or ECG, the diagnosis of syncope can be difficult with a low yield from echocardiography, ambulator ECG recording. electrophysiological study, and tilt table testing. During 2 years, 48 patients with unexplained syncope or presyncope from three hospitals in one city underwent the implantation of a Medtronic Reveal implantable loop recorder capable of cardiac monitoring for 14 months. All patients had at least two prior episodes of syncope or presyncope. Fifty-two percent of patients had electrophysiological studies, all of which were negative. The implantable loop recorder remained implanted until a diagnostic event was recorded, or until the end of the battery life. After a mean follow-up of 5.6 ± 5.7 months, symptoms reoccurred in 25 (52.1%) patients at a mean of 2.8± 2.1 months after insertion of an implantable loop recorder. No further symptoms occurred in 23 (47.9%) patients. Of the 25 patients who had a symptom and recorded an event, an arrhythmia was seen in 10 (40%) patients. Seven patients had bradycardia; 4 with profound sinus bradycardia/sinus arrest, 1 with complete heart block. and 2 in association with the cardioinhibitory component of vasovagal syncope. Three patients had tachycardias: two with supraventricular tachcardia and one with atrial flutter. Fifteen (60%) of the 25 patients who activated their device due to syncope or presyncope were in sinus rhythm during the event. The implantable loop recorder was effective in making a cardiological or noncardiological diagnosis for unexplained syncope or presyncope in 52.1% of the patients. [ABSTRACT FROM AUTHOR]
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