Use of an implantable loop recorder: initial experience

Retrospective analysis of the initial experience at our department with an implantable loop recorder (ILR) for the evaluation of patients with recurrent syncope, palpitations or dizziness.

We studied ten patients aged 31-65 (52.3) years referred to our center after an inconclusive evaluation that included ECG, Holter monitoring, events recorder, stress test, echocardiogram and electrophysiological study. Seven patients had structural heart disease. We used a Reveal Plus (Medtronic, USA) ILR, which allows up to 41 minutes of electrocardiographic recording, over a period of 24 months, patient or device activated, according to the programmed parameters. Follow-up was scheduled every three months or after every event activated by the patient. Symptoms and recorded events were analyzed.

Eight patients activated events, out of a total of 45 episodes, and five patients reported two or more symptoms. Dizziness was reported by five patients (24 episodes), palpitations by three (seven episodes), syncope by three (seven episodes) and nonspecific symptoms by five patients (seven episodes). The first symptom occurred between the twelfth day and the sixth month after implantation. Four episodes (three syncope and one dizziness) occurred with significant AV conduction disturbance (complete or high grade AV block) and in 41 episodes no rhythm or AV disturbance was recorded. Thirty events were automatically activated. There were no device-related complications. None of the patients died during follow-up.