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Importance of implantable loop recorder in patients with unexplaided syncope


Authors: R. Krausová
Published in: Kardiol Rev Int Med 2007, 9(3): 177-181

Overview

Conventional tests have known limitations in the diagnosis of syncope. Implantable loop recorder (ILR) is capable to monitor continuously ECG over a period of several months with an option to record signals during a period of symptoms after post hoc telemetric activation. ILR is a useful diagnostic tool in syncopal patients with infrequent symptoms and negative results of previous conventional tests.

Keywords:
long-term ECG monitoring, unexplained syncope, implantable loop recorder, bradyarrhythmia, tachyarrhythmia


Sources

1.Day SC, Cook EF, Funkenstein H et al. Eva­lua­tion and outco­me of emergency room pa­tients with transient loss of consciousness. Am J Med 1982; 73: 15–23.

2.Ka­poor WN, Karpf M, Weind S et al. A prospecti­ve eva­lua­tion and follow–up of pa­tients with synco­pe. N Engl J Med 1983; 309: 197–204.

3.Zi­metbaum PJ, Jo­sephson ME. The evolving ro­le of ambu­la­to­ry arrhythmia mo­ni­to­ring in ge­ne­ral cli­ni­cal practi­ce. Ann Intern Med 1999; 130: 848–856.

4.Ka­poor WN. Eva­lua­tion and outco­me of pa­tients with synco­pe. Me­di­ci­ne 1990; 69: 160–175.

5.Gibson TC, Heitzman MR. Diagnostic effi­ca­cy of 24–hour electro­cardiographic mo­ni­to­ring for synco­pe. Am J Cardiol 1984; 53: 1013–1017.

6.Clark PI, Glasser SO, Spo­to E. Arrhythmias de­tected by ambu­la­to­ry mo­ni­to­ring: Lack of corre­la­tion with symptoms of dizzi­ness and synco­pe. Chest 1980; 77: 722–725.

7.Di­Marco JP, Philbrick JT. Use of ambu­la­to­ry electro­cardiogra­fic (Holter) mo­ni­to­ring. Ann J Med 1990; 113: 53–68.

8.Bass EB, Curtiss EI, Are­na VC et al. The du­ra­tion of holter mo­ni­to­ring in pa­tients with synco­pe. Arch Intern Med 1990; 150: 1073–1078.

9.Linzer M, Pritchett EL, Ponti­nen M et al. Incre­mental diagnostic yield of loop electro­cardiographic re­corders in unexplai­ned synco­pe. Am J Cardiol 1990; 66: 214–219.

10.Fo­gel RI, Evans JJ, Prystowsky EN. Uti­li­ty and cost of event re­corders in the diagno­sis of palpi­ta­tions, pre­synco­pe and synco­pe. Am J Cardiol 1997; 79: 207–208.

11.Ka­poor WN, Smith NA, Miller NL. Upright tilt testing in eva­lua­ting synco­pe: a compre­hensi­ve li­te­ra­tu­re re­view. Am J Med 1994; 97: 78–88.

12.Klein GJ, Gersh BJ, Yee R. Electrophy­sio­lo­gi­cal testing: the fi­nal court of appeal for diagno­sis of synco­pe? Circu­la­tion 1995; 92: 1332–1335.

13.Brigno­le M, Albo­ni P, Benditt D et al. Task Force on Synco­pe, Euro­pean So­cie­ty of Cardio­lo­gy. Guide­li­nes on ma­na­ge­ment (diagno­sis and treatment) of synco­pe. Eur Heart J 2001; 22: 1256–1306.

14.Si­manti­ra­kis EN, Chry­sosto­ma­kis SI, Ma­nios EG et al. Insertable loop re­corder in unmasking the cause of synco­pe. Pa­cing Clin Electrophy­siol 2000; 23: 1573–1575.

15.Sra JS, An­der­son AJ, Sheikh SH et al. Unexplai­ned synco­pe eva­lua­ted by electrophy­sio­lo­gic stu­dies and head–up tilt testing. Ann Intern Med 1991; 114: 1013–1019.

16.Krahn AD, Klein GJ, Norris C at al. The etio­lo­gy of synco­pe in pa­tients with ne­ga­ti­ve tilt table and electrophy­sio­lo­gi­cal testing. Circu­la­tion 1995; 92: 1819–1824.

17.Krahn AD, Klein GJ, Yee R et al. The etio­lo­gy of synco­pe in pa­tients with ne­ga­ti­ve no­ninva­si­ve and inva­si­ve testing: fi­nal re­sults from a pi­lot stu­dy with implantable loop re­corder. Am J Cardiol 1998; 82: 117–119.

18.Krahn AD, Klein G, Norris C et al. The etio­lo­gy of synco­pe in pa­tients with ne­ga­ti­ve no­ninva­si­ve testing: fi­nal re­sults from a pi­lot stu­dy with an insertable lopp re­corder. Pa­cing Clin Electrophy­siol 1997; 20: 1077.

19.Krahn AD, Klen GJ, Yee R. Use of an extended mo­ni­to­ring stra­te­gy in pa­tients with proble­ma­tic synco­pe. Re­veal Investi­ga­tors. Circu­la­tion 1999; 99: 406–410.

20.Krahn AD, Klein GJ, Yee R. Re­cording that elu­si­ve rhythm. Can Med Assoc J 1999; 161: 1424–1425.

21.Krahn AD, Klein GJ, Yee R et al. Rando­mi­zed assesment of synco­pe trial: Conventio­nal diagnostic testing ver­sus a pro­longed mo­ni­to­ring stra­te­gy. Circu­la­tion 2001; 104: 46–51.

22.Seidl K, Breu­nung S, Ra­me­ken M et al. Ini­tial expe­rience with an implantable loop re­corder in pa­tients with unexplai­ned synco­pe. Z Kardiol 2000; 89: 43–50.

23.De­ha­ro JC, Je­go CH, Lanteau­meA et al. An implantable loop re­corde stu­dy og highly sympto­ma­tic va­so­va­gal pa­tients. J Am Coll Cardiol 2006; 47: 587–593.

24.Moya A, Brigno­le M, Me­nozzi C et al. Me­cha­nis­mus of synco­pe in pa­tients with iso­la­ted synco­pe and in pa­tients with tilt–po­si­ti­ve synco­pe. Circu­la­tion 2001; 104: 1261–1267.

25.Ashby DT, Ce­hic DA, Disney P et al. A retrospecti­ve ca­se stu­dy to assess the va­lue of the implanta­bi­le loop re­corder for the investi­ga­tion of undiagno­sed synco­pe. Pa­cing Clin Electrophy­siol 2002; 25: 1200–1205.

26.Nierop PR, Van Me­che­len R, Van Elsäcker A at al. Heart rhythm du­ring synco­pe and pre­synco­pe: Re­sults of implantable loop re­corders. Pa­cing Clin Electrophy­siol 2000; 23: 1532–1538.

27.Krau­so­vá R. Dlou­ho­do­bá EKG mo­ni­to­ra­ce po­mo­cí implanta­bilních sys­té­mů. V. čes­ké sym­po­zi­um o arytmiích a kardiosti­mu­la­ci, 7.–9. říj­na 1998, Olo­mouc (abstrakt).

28.Brigno­le M, Me­nozzi C, Moya A et al. Me­cha­nis­mus of synco­pe in pa­tients with bundle branch block and ne­ga­ti­ve electrophy­sio­lo­gi­cal test. Circu­la­tion 2001; 104: 2045–2050.

29.Muller U, Jochheim R, Knaup W et al. Implantable event re­corder: a new aid for the diagno­sis of arrhythmo­ge­nic synco­pe. Dtsch Med Wo­chenschr 1998; 123: 1378–1382.

30.Vardas PE. From the Eintho­ven galva­no­me­ter to the implantable loop re­corder: Re­ve­la­tions in sto­re. Pa­cing Clin Electrophy­siol 2000; 23: 1453–1455.

31.Giada F,Gu­li­zia M, France­se M. Re­current Unexplai­ned Palpi­ta­tions (RUP) Stu­dy. J Am Coll Cardiol; 49: 1951–1956.

32.Brigno­le M, Albo­ni P, Benditt DG et al. Guide­li­nes on ma­na­ge­ment (diagno­sis and treatment) of synco­pe–upda­te 2004. Euro­pa­ce 2004; 6: 467–537.

33.Klein G, Yee R, Gonsa­les J et al. Cost effecti­ve ana­ly­sis of diagnostic stra­te­gies in synco­pe of unknown etio­lo­gy. Circu­la­tion 1998; 94(Suppl I): 3655.

34.Krahn AD, Klein GJ, Yee R, Manda V. The high cost of synco­pe: cost impli­ca­tions of a new insertable loop re­corder in the investi­ga­tion of reccu­rent synco­pe. Am Heart J 1999; 137: 870–877.

35.Assar MD, Krahn AD, Klein GJ et al. Risk of reccu­rent synco­pe after ne­ga­ti­ve implantable loop re­corder mo­ni­to­ring: Long–term follow–up of 26 pa­tients. Pa­cing Clin Electrophy­siol 2002; 25: 571 (abstrakt).

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Paediatric cardiology Internal medicine Cardiac surgery Cardiology
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