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Diagnostic value of implantable loop recorders in patients with unexplained syncope or palpitations

Nikola N Radovanović1, Siniša U Pavlović1,2, Bratislav Kirćanski1,2

  • 1Pacemaker Center, Clinical Center of Serbia, Belgrade, Serbia.

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|June 7, 2021
PubMed

Insights

The implantable loop recorder (ILR) diagnosed cardiac arrhythmias in 54.1% of patients with unexplained syncope or palpitations. For recurrent palpitations, ILR diagnostic value was lower, suggesting earlier implantation in syncope evaluations.

Area of Science:

  • Cardiology
  • Medical Devices
  • Diagnostic Technology

Background:

  • The implantable loop recorder (ILR) is a compact cardiac rhythm-monitoring device.
  • Unexplained syncope, presyncope, and palpitations can indicate cardiac arrhythmias.

Purpose of the Study:

  • To assess the diagnostic utility of the implantable loop recorder (ILR).
  • To evaluate ILR effectiveness in patients experiencing unexplained syncope, presyncope, or palpitations suggestive of cardiac arrhythmias.

Main Methods:

  • A retrospective, observational, single-center study.
  • 181 patients received an ILR between January 2006 and July 2019.
  • Diagnostic value was determined by whether the ILR led to a diagnosis or verified/excluded arrhythmia as the cause of symptoms.

Main Results:

  • The implantable loop recorder (ILR) was diagnostic in 54.1% of patients (98 out of 181).
  • The mean follow-up was 20.2 months, with a mean time to a diagnostic event of 11.1 months.
  • No significant difference in ILR diagnostic value was observed based on baseline patient characteristics or prior diagnostic procedures.

Conclusions:

  • The implantable loop recorder (ILR) achieved an etiological diagnosis in 54.1% of patients with unexplained symptoms suggestive of cardiac arrhythmias.
  • ILR demonstrated significantly lower diagnostic value in patients with recurrent palpitations compared to those with syncope or presyncope.
  • The study recommends earlier implantation of ILR in the syncope evaluation process.
Abstract

Keywords:
arrhythmiaimplantable loop recorderpalpitationssyncope

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