Document Detail


Value of the implantable loop recorder for the management of patients with unexplained syncope.
MedLine Citation:
PMID:  14697729     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Recurrent syncope often remains unexplained despite extensive multidisciplinary screening. The implantable loop recorder (ILR) may be a tool to define the cardiac arrhythmias underlying syncope. METHODS AND RESULTS: The study population consisted of 43 consecutive patients with unexplained syncope who underwent extensive cardiological screening and were followed with an ILR. During follow-up, 5 patients had only presyncope, 4 had palpitations, and 15 had a true recurrence of syncope. In all patients with palpitations, 3 with presyncope, and 7 with a recurrence of syncope, the ILR excluded arrhythmias. In the patients with a true recurrence, 1 had symptomatic paroxysmal atrial fibrillation (PAF) treated with drugs, 1 had polymorphic ventricular tachycardia (VT) and received an implantable cardioverter defibrillator (ICD), and 7 had asystole and received a pacemaker. Two patients with presyncope received a pacemaker for Mobitz II block and PAF with brady-tachycardia syndrome. One asymptomatic patient received a pacemaker for significant nocturnal asystole recorded by ILR. Abnormalities in the cardiac screening were observed both in patients with and without syncope, but none of these had a predictive value. CONCLUSION: The ILR is a valuable and effective tool to establish an arrhythmic cause for unexplained syncope. The results of head-up tilt testing (HUTT) and electrophysiological study (EPS) are neither sufficiently sensitive nor specific enough in this patient group.
Authors:
Lucas Boersma; Lluís Mont; Alessandro Sionis; Emilio García; Josep Brugada
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  6     ISSN:  1099-5129     ISO Abbreviation:  Europace     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2003-12-30     Completed Date:  2004-06-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  70-6     Citation Subset:  IM    
Affiliation:
Cardiology Department, St. Antonius Hospital, Heart Lung Center Utrecht, PO 2500, 3430 EM Nieuwegein, The Netherlands. l.boersma@antonius.net
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Arrhythmias, Cardiac / complications,  diagnosis*
Electrocardiography / instrumentation*
Electrodes, Implanted
Female
Humans
Male
Middle Aged
Monitoring, Ambulatory
Outcome Assessment (Health Care)
Recurrence
Syncope / etiology*
Tilt-Table Test

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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