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[Recurrent syncope of unknown origin. Diagnosis with implantable "loop" recorders]
J Sperzel1, J Carlsson, A Erdogan
1Abteilung für Kardiologie, Kerckhoff-Klinik, Bad Nauheim.
Insights
Recurrent syncope diagnosis is challenging. An implantable loop recorder aided in diagnosing sinus node arrest in a patient with unexplained syncope, leading to successful pacemaker implantation and symptom resolution.
Area of Science:
- Cardiology
- Neurology
Background:
- Recurrent syncope diagnosis remains elusive in approximately one-third of cases, even after extensive cardiovascular and neurologic evaluations.
- Conventional diagnostic methods exhibit low sensitivity, particularly in patients without underlying heart disease.
Observation:
- A 33-year-old male patient with unexplained syncope underwent implantation of a Reveal (implantable loop recorder) following negative neurological and cardiovascular testing.
- One month post-implantation, the device documented sinus node arrest during a presyncope episode.
Findings:
- The implantable loop recorder successfully identified the cause of syncope as sinus node arrest.
- The patient subsequently received a pacemaker and has remained asymptomatic.
Implications:
- Implantable loop recorders are valuable tools for diagnosing syncope when conventional testing fails.
- This technology offers a cost-effective solution for identifying the etiology of recurrent syncope, improving patient outcomes.
Background:
In about a third of cases of recurrent syncope a diagnosis cannot be established despite extensive cardiovascular and neurologic testing. In patients without underlying heart disease the sensitivity of conventional diagnostic testing is low.
Case Report:
A 33-year-old male patient underwent implantation of a loop recorder (Reveal) after negative neurological and cardiovascular testing. One month after implantation sinus node arrest could be documented during a presyncope. The patient underwent pacemaker implantation and remains asymptomatic since then.
Conclusion:
In patients with syncope and a negative conventional diagnostic workup the implantable loop recorder is a helpful and cost-effective diagnostic tool.