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Implantable loop recorder undersensing mimicking complete heart block
S I Chrysostomakis1, E N Simantirakis, M E Marketou
1Cardiology Department, University Hospital of Heraklion, Crete, Greece.
Summary
Newer implantable loop recorders with auto-activation may misdiagnose heart block due to undersensing. Careful interpretation is crucial to prevent false positive diagnoses in patients with syncope.
Area of Science:
- Cardiology
- Medical Devices
- Diagnostic Technology
Background:
- Implantable loop recorders (ILRs) with auto-activation features are increasingly used for diagnosing syncopal episodes.
- These devices aim to improve diagnostic yield in patients with unexplained syncope.
Observation:
- A case study involving a male patient experiencing pre-syncope and syncope without underlying organic heart disease.
- The patient's ILR (Reveal Plus) auto-activated due to undersensing.
- The recorded cardiac rhythm strip mimicked complete heart block.
Findings:
- Auto-activation of ILRs can be triggered by technical issues like undersensing.
- Device-generated rhythm strips may inaccurately represent the patient's true cardiac condition.
- False positive findings, such as simulated complete heart block, can occur.
Implications:
- Interpreters of ILR data must exercise heightened vigilance to avoid misdiagnosis.
- Potential for unnecessary and potentially harmful therapeutic interventions based on false positive findings.
- Clinical protocols may need refinement to address artifact-related data from auto-activated ILRs.