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Implantable loop recorder is an effective diagnostic tool for unexplained syncope.

Ann Bovin1, Jerzy Malczynski, Dorthe Dalsgaard

  • 1Department of Medicine, Herning Regional Hospital, Denmark. annbovin@post.cybercity.dk

Danish Medical Journal
|November 20, 2012
PubMed
Summary

An implantable loop recorder (ILR) effectively diagnosed the cause of recurrent, unexplained syncope in 56% of patients. This tool is valuable for identifying cardiac arrhythmias and ruling out other causes.

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Area of Science:

  • Cardiology
  • Medical Devices

Background:

  • Cardiac syncope is associated with higher mortality compared to non-cardiac causes.
  • Syncope of unknown etiology represents an intermediate risk group requiring further investigation.
  • Unexplained syncope necessitates accurate diagnosis to guide appropriate management and improve patient outcomes.

Purpose of the Study:

  • To evaluate the diagnostic yield of implantable loop recorders (ILRs) in patients with recurrent, unexplained syncope.
  • To determine the effectiveness of ILRs in establishing the cause of syncope, particularly cardiac arrhythmias.
  • To assess the utility of ILRs in ruling out arrhythmia as a cause of syncope.

Main Methods:

  • Retrospective single-centre study.
  • Inclusion of 44 patients who received an implantable loop recorder (ILR) between 2007 and 2011.
  • Analysis of follow-up data for 39 patients, with a mean follow-up period of 349 days.

Main Results:

  • Diagnoses were established in 22 patients (56%) of the study cohort.
  • In 64% of diagnosed cases, the cause of syncope was identified as cardiac.
  • The average time to the first documented syncopal recurrence with ECG was 244 days.

Conclusions:

  • Implantable loop recorders (ILRs) are effective in diagnosing arrhythmic causes of recurrent, unexplained syncope.
  • ILRs are useful for excluding arrhythmia as a cause of syncope.
  • Further research, including randomized controlled trials, is needed to optimize ILR use and evaluate its impact on recurrence rates and mortality.