Additional Diagnostic Value of Very Prolonged Observation by Implantable Loop Recorder in Patients with Unexplained Syncope
| Autor: | Toshiyuki Furukawa, Cristina Bertolone, Roberto Maggi, Daniele Fontana, Michele Brignole |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Heart disease Cross-sectional study Kaplan-Meier Estimate Syncope Heart Rate Predictive Value of Tests Physiology (medical) Heart rate medicine Implantable loop recorder Humans Medical diagnosis Aged Aged 80 and over Bundle branch block medicine.diagnostic_test business.industry Arrhythmias Cardiac Middle Aged medicine.disease Electrodes Implanted Surgery Cross-Sectional Studies Italy Predictive value of tests Electrocardiography Ambulatory Female Cardiology and Cardiovascular Medicine business Electrocardiography |
| Zdroj: | Journal of Cardiovascular Electrophysiology. 23:67-71 |
| ISSN: | 1045-3873 |
| DOI: | 10.1111/j.1540-8167.2011.02133.x |
| Popis: | Long-Term Observation with ILR. Introduction: In the literature, the average diagnostic yield of the implantable loop recorder (ILR) is reported to be 35% over an observation period generally less than 18 months. The aim of this study was to evaluate the diagnostic value of ILR during very prolonged observation. Methods and Results: Consecutive patients who had received one or more (in the case of battery exhaustion before diagnosis) ILR (Reveal/plus/DX, Medtronic Inc.) from 2001 to 2010 were included. The diagnostic ECG was classified according to the ISSUE classification. We analyzed 157 patients (87 males, 69 ± 14 years): 70 of these were followed up for ≥18 months. The estimated cumulative diagnostic rates were 30%, 43%, 52%, and 80% at 1, 2, 3, and 4 years, respectively; 26% of diagnoses were made after 18 months. The diagnostic yield was independent of structural heart disease, bundle branch block, number of syncopes, age, and gender; the median time to diagnosis of ISSUE type 1 patients was shorter than that of the others (4 [2;10] vs. 16 [6;23] months; P = 0.003). During the observation period, 3 patients (1.9%) died and none suffered arrhythmic death. Conclusions: Prolonging observation up to 4 years increased the diagnostic value of ILR in syncopal patients and was safe. A quarter of patients diagnosed needed more than 18 months of follow-up. As consequence, when a strategy of prolonging monitoring is chosen, monitoring should be maintained even for several years until diagnosis is established. (J Cardiovasc Electrophysiol, Vol. 23, pp. 67-71, January 2012) |
| Databáze: | OpenAIRE |
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