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Updated: Feb 24, 2026

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
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Outcome of implantable loop recorder evaluation.

Peter M Magnusson1, Maciej Olszowka, Marita Wallhagen

  • 1Karolinska Institutet, Stockholm, SWEDEN. peter.magnusson@regiongavleborg.se.

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|August 26, 2017
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Summary

Implantable loop recorders (ILRs) effectively diagnose arrhythmias in syncope patients, with 28.1% requiring pacemakers or ICDs. Advanced age is the main predictor, and prolonged monitoring is often necessary for diagnosis.

Keywords:
cardiac arrhythmiaelectrocardiography monitoringimplantable loop recorderpacemakersyncope

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Implantable loop recorders (ILRs) are used for diagnosing unclear syncope.
  • Evaluating ILR utility in an unselected patient cohort is crucial for understanding their real-world diagnostic yield and impact on treatment decisions.

Purpose of the Study:

  • Assess the diagnostic yield of ILRs in identifying arrhythmias requiring pacemaker or implantable cardioverter-defibrillator (ICD) implantation.
  • Determine the time to device implantation and identify predictors of successful diagnosis.
  • Evaluate safety issues and the role of preceding diagnostic tools in syncope management.

Main Methods:

  • Retrospective analysis of medical records from 173 patients who underwent ILR evaluation between 2007 and 2013.
  • Logistic regression and Kaplan-Meier estimates were used to analyze diagnostic outcomes and time-dependent factors.
  • Predictors for pacemaker/ICD implantation were assessed using odds ratios (ORs).

Main Results:

  • In 146 patients evaluated for syncope, 28.1% received a pacemaker (n=39) or ICD (n=2).
  • The cumulative incidence of device implantation reached 26.7% by 18 months.
  • Advanced age (>75 years) was the sole significant predictor (p=0.010); elevated B-type natriuretic peptide, trauma history, and abnormal ECG showed trends toward significance.

Conclusions:

  • ILRs diagnosed arrhythmias necessitating pacemaker/ICD in 28.1% of an unselected syncope cohort.
  • Advanced age is the primary predictor for device implantation.
  • Diagnosis timing is unpredictable, underscoring the need for prolonged ILR monitoring and optimal use of other diagnostic tools.