| Detection of asymptomatic arrhythmias in unexplained syncope. | |
| | |
MedLine Citation:
|
PMID: 15309004 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Although electrocardiographic monitoring during syncope is the most unambiguous method of diagnosing or excluding an arrhythmia, it requires recurrence of syncope with potential morbidity. We hypothesized that long-term monitoring of patients with syncope would yield significant asymptomatic abnormalities that might preclude waiting for recurrence of actual syncope. METHODS: Sixty patients (age, 67+/-16 years; 27 men) with recurrent unexplained syncope, aged >or=30 years, with a left ventricular ejection fraction >or=35% and negative results on conventional monitoring were enrolled in a prospective study involving long-term automatic arrhythmia detection monitoring with an implantable loop recorder. Pre-specified significant asymptomatic arrhythmias were a pause >5 seconds, 3 degrees atrioventricular block >10 seconds, heart rate (HR) <30 beats/min for >10 seconds while awake, wide complex tachycardia >10 beats, and narrow complex tachycardia >180 beats/min for >30 beats. Borderline asymptomatic arrhythmias included 3- to 5-second pauses, HR <30 beats/min for <10 seconds while awake, HR <30 beats/min for >10 seconds while asleep, and nonsustained wide complex tachycardia or narrow complex tachycardia. RESULTS: Recurrent symptoms developed in 30 patients during the 1-year follow-up period (47%), with arrhythmias detected in 14 patients (23%). Pre-specified significant asymptomatic arrhythmias developed in 9 patients (15%), with bradycardia in 7 patients who underwent pacemaker implantation. Twenty patients (33%) had borderline asymptomatic arrhythmias. Five of these patients (25%) went on to have more pronounced diagnostic arrhythmias of the same mechanism during further follow-up, including pauses of 6 to 17 seconds duration in 3 patients. CONCLUSION: Long-term monitoring of patients with unexplained syncope with automatic arrhythmia detection demonstrated that significant asymptomatic arrhythmias were seen more frequently than anticipated, leading to a change in patient treatment. Automatic arrhythmia detection provides incremental diagnostic usefulness in long-term monitoring of patients with syncope. |
| | |
Authors:
|
Andrew D Krahn; George J Klein; Raymond Yee; Allan C Skanes |
Related Documents
:
|
22989794 - Resolution of cervical syringomyelia after transoral odontoidectomy and occipitocervica... 15562934 - Hemodynamic significance of heart rate in neurally mediated syncope. 9498944 - Diminished short-term heart rate variability predicts inducible ventricular tachycardia. 1279614 - Antiarrhythmic efficacy of ethacizine assessed by programmed electrical stimulation in ... 12122174 - Bladder dysfunction in acute transverse myelitis: magnetic resonance imaging and neurop... 7247784 - Late response and sural conduction studies. usefulness in patients with chronic renal f... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: American heart journal Volume: 148 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2004 Aug |
Date Detail:
|
Created Date: 2004-08-13 Completed Date: 2005-01-13 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
|
Languages: eng Pagination: 326-32 Citation Subset: AIM; IM |
Affiliation:
|
Division of Cardiology, University of Western Ontario, London, Ontario, Canada. akrahn@uwo.ca |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Arrhythmias, Cardiac / complications, diagnosis* Bradycardia / diagnosis Electrocardiography, Ambulatory* / instrumentation Female Follow-Up Studies Humans Middle Aged Prospective Studies Recurrence Stroke Volume Syncope / etiology* Tachycardia / diagnosis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Quality of life restored to normal in patients with atrial fibrillation after pulmonary vein ostial ...
Next Document: Assessment of plaque vulnerability by angioscopic classification of plaque color.