Implantable loop recorder in unexplained palpitations or syncope: A randomised study among young patients with...

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• Unexplained syncope and palpitations in young patients often pose diagnostic challenges.
• The utility of implantable loop recorders (ILRs) in this demographic, particularly without structural heart disease, requires further investigation.
• Conventional extended Holter monitoring may have limitations in diagnosing infrequent arrhythmias.

Purpose of the Study:

• To compare the diagnostic yield of ILR versus conventional extended Holter monitoring.
• To evaluate the effectiveness of ILR in detecting arrhythmias in young patients with structurally normal hearts presenting with unexplained palpitations or syncope.

Main Methods:

• An open-label, randomized controlled trial was conducted in a tertiary cardiac care center.
• Young patients with recurrent unexplained palpitations or syncope and normal cardiac evaluations were enrolled.
• Participants were randomized to either ILR implantation or conventional extended Holter monitoring.

Main Results:

• The ILR group achieved a significantly higher diagnostic yield (71.5%) compared to the conventional group (18.7%) (p=0.01).
• Arrhythmias diagnosed by ILR included various tachycardias, atrial fibrillation, VPCs, and bradycardia with sinus arrest.
• The study included 14 patients in the ILR group and 16 in the conventional group, with a mean age around 31 years.

Conclusions:

• Implantable loop recorders offer a superior diagnostic yield for detecting arrhythmias in young patients with unexplained syncope or palpitations.
• ILR implantation facilitates more accurate diagnosis and consequently improves patient management strategies.
• The findings support the use of ILR as a valuable tool in the cardiological evaluation of unexplained syncope and palpitations in young individuals.