Predictors of future arrhythmic events in patients with unexplained syncope
Dirk Prochnau1,2, Tobias Lambert1, Holger Sigusch3
1a Department of Internal Medicine I , Jena University Hospital , Jena , Germany.
Acta Cardiologica
|July 7, 2017
Summary
Implantable loop recorders (ILRs) effectively link syncope symptoms to heart rhythms. Older age is the only identified predictor of future arrhythmic events in patients with unexplained syncope.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Unexplained syncope poses diagnostic challenges.
- Implantable loop recorders (ILRs) offer prolonged cardiac rhythm monitoring.
Purpose of the Study:
- To evaluate the utility of ILRs for correlating syncope symptoms with cardiac arrhythmias.
- To identify predictors of subsequent arrhythmic events in patients with unexplained syncope.
Main Methods:
- A dual-center study analyzed ILR data from 189 patients with unexplained syncope.
- Patients had a mean age of 67.4 years and significant comorbidities.
- Median ILR monitoring duration was 29 months.
Main Results:
- 26% of patients experienced syncope recurrence, with a median time to recurrence of 8 months.
- Pacemaker or ICD implantation was performed in 49 patients based on ILR findings.
- Older age (OR 1.3, p=0.039) was a significant predictor of future arrhythmic events.
Conclusions:
- ILR monitoring is effective for diagnosing the causes of unexplained syncope.
- Age is the sole identified predictor for future arrhythmic events.
- The mortality rate in this cohort with unexplained syncope was notably low.
More Related Videos
Related Concept Videos
01:30Dysrhythmias V: Evaluating Dysrhythmias
422
Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
422
01:29Disturbances in Heart Rhythm
3.3K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
3.3K
01:28Mechanism of Cardiac Arrhythmias
2.4K
Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
2.4K
01:28Dysrhythmias II: Classification of Tachyarrhythmias
696
Tachyarrhythmias are a type of dysrhythmia where the heart rate exceeds 100 beats per minute. Here are some common types of tachyarrhythmias:Sinus TachycardiaSinus tachycardia originates from increased impulses from the sinus node, leading to an elevated heart rate. It is often triggered by stress, fever, or exercise.Patients may experience palpitations, a sensation of a racing heart, dizziness, and chest discomfort.Causes and Risk Factors: Common causes include physical exertion, emotional...
696
01:25Dysrhythmias VII: Nursing Management of Dysrhythmias
464
Nursing management of dysrhythmias involves the following:AssessmentSubjective Assessment:The initial step involves gathering patient-reported symptoms such as dizziness, palpitations, and chest discomfort. It is crucial to collect a detailed history, including previous heart conditions, current medication use, and lifestyle factors like caffeine and alcohol consumption.Objective Assessment:This involves observing clinical signs such as jugular venous distention, cool and pale skin, and...
464
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
672
Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
672