Usefulness of implantable loop recorders in office-based practice for evaluation of syncope in patients with and without structural heart disease

doi:10.1016/j.amjcard.2003.07.011

The American Journal of Cardiology

Volume 92, Issue 9, 1 November 2003, Pages 1127-1129

https://doi.org/10.1016/j.amjcard.2003.07.011 Get rights and content

Abstract

Early use of an implantable loop recorder for evaluating unexplained syncope in an office-based electrophysiology practice is an effective approach in patients with and without structural heart disease. Documentation of rhythm with an implantable loop recorder at the time of symptoms is possible in approximately 50% and 80% of patients in both groups after 1 and 2 years of follow-up, respectively.

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There are more references available in the full text version of this article.

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Citation Excerpt :
Also, every 2–3 years the device needs to be replaced and it has a relatively high cost compared to the short term ECG monitors. This device has been proven as a feasible diagnostic tool to diagnose syncope.35 Compared to intermittent monitoring, there is an advantage of using continuous monitoring, even when compared to more aggressive intermittent monitoring strategies.
Ambulatory ECG monitoring technology has rapidly evolved over the last few decades and has been shown to identify life-threatening and non-life threatening arrhythmias and provide actionable data to guide clinical decision making. Atrial fibrillation episodes can often be asymptomatic, even after catheter ablation for atrial fibrillation, creating a disconnect between symptoms and actual arrhythmia burden which may alter clinical management. In this review, we aim to provide a comprehensive overview of invasive and non-invasive ECG monitoring strategies in patients with atrial fibrillation, with a special focus on the diagnosis of atrial fibrillation, and on follow-up of patients after catheter ablation for atrial fibrillation ablation.
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Increased sensitivity of electrophysiological study by isoproterenol infusion in unexplained syncope
2006, International Journal of Cardiology
The purpose of the study was to evaluate the interests of electrophysiologic study (EPS) after infusion of isoproterenol in patients with syncope and negative EPS in control state.
1350 patients were consecutively admitted for syncope and EPS. Patients were included if they had no history of tachycardia, a normal Holter monitoring, a negative EPS in control state. EPS was repeated after infusion of 2–4 μg/kg of isoproterenol.
256 patients, 35 with exercise-related syncope and 105 with heart disease (HD), were recruited. After isoproterenol, an arrhythmia was identified as the sign associated with syncope in 102 patients (40%): SVT in 32 patients, VT in 36 patients, infrahisian 2nd or 3rd degree AV block in three patients and vasovagal reaction in 31 patients. Arrhythmias were more frequent in patients with HD (50/105) than in those without HD (52/151) (p < 0.05); SVT tended to be more frequent in patients without HD (n = 23) than in those with HD (n = 9) (p < 0.1); VT was more frequent in patients with HD (n = 26) than in those without HD (n = 10) (p < 0.001). There was no relationship between a positive isoproterenol testing and occurrence of syncope at exercise (19/35 vs 81/221) (p < 0.1).
isoproterenol infusion increased the sensitivity of EPS in patients with syncope, related or not to exercise, and with negative study in control state, but principally in those with HD. However, SVT was diagnosed in patients without HD and EPS associated with isoproterenol infusion remained an important and rapid tool to establish this diagnosis.
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Unexplained syncope revealed by an implantable loop recorder: Case report illustrating the interest in diagnosing the cause of syncope in the year 2011
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^☆: This study was supported by Medtronic, Inc., Minneapolis, Minnesota.

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Usefulness of implantable loop recorders in office-based practice for evaluation of syncope in patients with and without structural heart disease☆

Abstract

Am J Cardiol

Am Heart J