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Implantable loop recorder syncope

Rafi Sakhi, Dominic A M J Theuns, Rohit E Bhagwandien, Michelle Michels, Arend F L Schinkel, Tamas Szili-Torok, F Zijlstra, Jolien W Roos-Hesselink, Sing-Chien Yap
PURPOSE: In patients with structural heart disease (SHD) or inherited primary arrhythmia syndrome (IPAS), the occurrence of unexplained syncope or palpitations can be worrisome as they are at increased risk of sudden cardiac death. An implantable loop recorder (ILR) can be a useful diagnostic tool. Our purpose was to compare the diagnostic yield, arrhythmia mechanism, and management in patients with SHD, patients with IPAS, and those without heart disease. METHODS: Retrospective single-center study in consecutive patients who underwent an ILR implantation...
March 13, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Martin Huemer, Ann-Kristin Becker, Alexander Wutzler, Philipp Attanasio, Abdul S Parwani, Philipp Lacour, Leif-Hendrik Boldt, Burkert Pieske, Wilhelm Haverkamp, Florian Blaschke
BACKGROUND: Implantable loop recorders (ILR) are a valuable tool for the investigation of unexplained syncopal episodes. The aim of this retrospective single center study was to identify predictive factors for pacemaker implantation in patients with unexplained syncope who underwent ILR insertion. METHODS: 106 patients were retrospectively analyzed (mean age 59.1 years; 47.2% male) with unexplained syncope and negative conventional testing who underwent ILR implantation...
February 5, 2018: Cardiology Journal
Valentina De Regibus, Darragh Moran, Gian Battista Chierchia, Pedro Brugada, Carlo de Asmundis
Vasovagal syncope is characterized by vasodilatation and/or bradycardia and thereby a fall in arterial BP and global cerebral perfusion in response to a trigger. Although it is a benign condition, patients with frequent and traumatic episodes need treatment in order to improve quality of life. We describe the case of a 17-years-old boy suffering from cardioinhibitory syncope. At the end of a complete negative cardiac and neurological examination, a loop recorder was implanted. During the subsequent follow-up the ILR documented a 9-s pause...
December 21, 2017: Indian Pacing and Electrophysiology Journal
Omar A Ibrahim, Doran Drew, Christopher J Hayes, William McIntyre, Colette M Seifer, Wilma Hopman, Benedict Glover, Adrian M Baranchuk
PURPOSE: Implantable loop recorders (ILRs) are increasingly being used for ambulatory electrocardiography. We sought to evaluate ILR indications, diagnostic yield, ILR-guided interventions, and complications in two Canadian centers. METHODS: This was a retrospective study using electronic medical records to identify ILR implants at Queen's University and the University of Manitoba. Information was collected on patient characteristics, medications, indication for implant, results of prior investigations, diagnostic outcome, and subsequent management...
November 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Wanlu Zhou, Bilian Chen
Syncope is a clinical symptom for many kinds of diseases. The reasons for some syncope are still not clear even after a comprehensive and systematic examination, known as unexplained syncope. The clinical data of one patient with recurrent syncope, who had received the implanted loop recorder (ILR) in Xiangya Hospital, Central South University, were retrospectively analyzed. The instrument recorded the first syncope at a time of recurrence for the sustained ventricular tachycardia in 704 days after ILR. The patient was thus diagnosed as arrhythmic syncope and received an operation with implantable cardioverter defibrillator...
October 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Peter M Magnusson, Maciej Olszowka, Marita Wallhagen, Hirsh Koyi
BACKGROUND: The aim of this study was to evaluate implantable loop recorders (ILRs) in an unselected cohort in order to determine diagnostic yield, time to pacemaker/implantable cardioverter defibrillator (ICD) implantation, predictors thereof, safety issues, and syncope management including usage of preceding diagnostic tools. METHODS: Patients who underwent ILR evaluation in any of three centers in Region Gävleborg, Sweden, between April 2007 and April 2013 were included and their medical records retrieved...
August 25, 2017: Cardiology Journal
Andrea DI Cori, Raffaele DE Lucia
Long term ECG monitoring has become nowadays an indispensable technology for prevention, management and treatment of many cardiac issues. Today long term ECG monitoring is achievable through loop recorders (LR) and cardiac devices (CIED) like pacemaker (PM), implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy device-defibrillators (CRT- Ds), all of which associated with remote monitoring (RM). Targeted long term ECG monitoring Patients who have recurrent non documented episodes of palpitations, unexplained episodes of syncope, cryptogenic stroke or patients with a cardiomiopathy needing a risk stratification, may benefit from long term ECG monitoring...
July 18, 2017: Minerva Cardioangiologica
Dirk Prochnau, Tobias Lambert, Holger Sigusch, Ralf Surber, Paul Christian Schulze
AIMS: The purpose of this study was to examine the usefulness of implantable loop recorders (ILRs) for symptom-rhythm correlation and to identify predictors of future arrhythmic events. PATIENTS AND METHODS: In our dual-centre study, we analysed ILR data of 189 patients (mean age 67.4 ± 15.2 years, 114 male) with unexplained syncope (single syncope 21 patients, recurrent 168 patients, traumatic injury 43 patients). Patients had severe comorbidities such as hypertension (n = 127), coronary artery disease (n = 31), diabetes mellitus (n = 33) and chronic renal insufficiency (n = 18)...
October 2017: Acta Cardiologica
B O'Brien, H Zafar, F Sharif
A strong evidence of outcomes for vasovagal syncope is not easily identified. It would seem reasonable that the proposed Mayo Clinic technology would be reserved for cases with severe recurrent or refractory syncope. However, recurrence levels are relatively low, and while some predictive methods have been proposed, recurrence is also influenced by the interaction that occurs during screening and examinations, i.e. recurrence diminishes once an initial diagnosis has been made. Finally, a key factor in being able to identify suitable patients relates to understanding the relative significance of the vasodepression and cardioinhibitory components-the therapy is best suited to patients that have a significant level of both components...
June 14, 2017: Irish Journal of Medical Science
Carla Giustetto, Natascia Cerrato, Enrico Ruffino, Elena Gribaudo, Chiara Scrocco, Lorella Barbonaglia, Francesca Bianchi, Miriam Bortnik, Guido Rossetti, Paula Carvalho, Riccardo Riccardi, Davide Castagno, Matteo Anselmino, Laura Bergamasco, Fiorenzo Gaita
BACKGROUND: Syncope is considered a risk factor for life-threatening arrhythmias in Brugada patients. Distinguishing a benign syncope from one due to ventricular arrhythmias is often difficult, unless an ECG is recorded during the episode. Aim of the study was to analyze the characteristics of syncopal episodes in a large population of Brugada patients and evaluate the role of electrophysiological study (EPS) and the prognosis in the different subgroups. METHODS AND RESULTS: One hundred ninety-five Brugada patients with history of syncope were considered...
August 15, 2017: International Journal of Cardiology
Mathieu Le Bloa, Jean-Benoît Thambo
The number of children and adult with congenital heart disease requiring implantation of cardiac pacemaker or cardioverter defibrillator is constantly increasing. The lead between stimulation/defibrillation site and the generator constitutes the main weakpoint of those devices despite the numerous recent technological advances: use of bipolar probes, corticoid elution electrodes, insulation improvement, magnetic resonance imaging (MRI) compatibility. Risk of device failure remains high in this population. Long term adverse events with endovascular devices remain high...
June 2017: La Presse Médicale
Hoang H Nguyen, Ian H Law, Michael W Rudokas, Jennifer Lampe, Tammy M Bowman, George F Van Hare, Jennifer N Avari Silva
OBJECTIVES: To compare the procedure, recovery, hospitalization times, and costs along with patient/parent satisfaction after newer-generation cardiac implantable loop recorder (Reveal LINQ; Medtronic Inc, Minneapolis, Minnesota) and previous-generation implantable loop recorder (Reveal XT; Medtronic Inc). STUDY DESIGN: A prospective study of patients undergoing LINQ implantations between April 2014 and October 2015 was performed. Retrospective chart review of patients undergoing XT implantations was performed for comparison...
August 2017: Journal of Pediatrics
Francisco J Guerrero-Márquez, Eduardo Arana-Rueda, Alonso Pedrote
Idiopathic paroxysmal atrioventricular (AV) block poses a true diagnostic challenge. What is clear about this entity is the confusion about its definition and consequently about its etiology. According to certain sources, the diagnosis of this block requires the lack of a structural cardiac pathology that justifies the observed manifestations and an absence of electrocardiographic disorders prior to an episode. The clinical presentation of idiopathic paroxysmal AV block does not differ from that of another cardiogenic syncope or of a vasovagal syncope with a significant cardioinhibitory component...
October 2016: Journal of Atrial Fibrillation
Peter Mitro, Miloš Šimurda, Ervin Müller
BACKGROUND: The aim of this retrospective single center cohort study was to assess the occurrence of bradycardia during implantable loop recorder (ILR) monitoring in patients with unexplained syncope and negative conventional testing and to identify clinical predictors of bradycardia and pacemaker implantation. METHODS: An ILR was implanted in 112 patients (31 men, 81 women, mean age 64 ±13 years) with syncope which was not explained after conventional diagnostic work-up...
July 2017: Wiener Klinische Wochenschrift
Paul D Varosy, Lin Y Chen, Amy L Miller, Peter A Noseworthy, David J Slotwiner, Venkatesh Thiruganasambandamoorthy
OBJECTIVES: To determine, using systematic review of the biomedical literature, whether pacing reduces risk of recurrent syncope and relevant clinical outcomes among adult patients with reflex-mediated syncope. METHODS: MEDLINE (through PubMed), EMBASE, and the Cochrane Central Register of Controlled Trials (through October 7, 2015) were searched for randomized trials and observational studies examining pacing and syncope, and the bibliographies of known systematic reviews were also examined...
August 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Paul D Varosy, Lin Y Chen, Amy L Miller, Peter A Noseworthy, David J Slotwiner, Venkatesh Thiruganasambandamoorthy
OBJECTIVES: To determine, using systematic review of the biomedical literature, whether pacing reduces risk of recurrent syncope and relevant clinical outcomes among adult patients with reflex-mediated syncope. METHODS: MEDLINE (through PubMed), EMBASE, and the Cochrane Central Register of Controlled Trials (through October 7, 2015) were searched for randomized trials and observational studies examining pacing and syncope, and the bibliographies of known systematic reviews were also examined...
August 1, 2017: Journal of the American College of Cardiology
Monica Solbiati, Giovanni Casazza, Franca Dipaola, Franca Barbic, Maja Caldato, Nicola Montano, Raffaello Furlan, Robert S Sheldon, Giorgio Costantino
BACKGROUND: Guidelines recommend that implantable loop recorders (ILRs) are used in the evaluation of people with recurrent unexplained syncope in the absence of high-risk criteria, and in high-risk patients after a negative evaluation. The aim of this systematic review was to analyze the diagnostic yield of ILRs in these patients. METHODS: We performed a systematic search in order to retrieve studies enrolling adults undergoing ILR implantation for undetermined syncope...
March 15, 2017: International Journal of Cardiology
Inês Silveira, Maria João Sousa, Nuno Antunes, Vânia Silva, Carla Roque, António Pinheiro-Vieira, Vítor Lagarto, António Hipólito-Reis, André Luz, Severo Torres
Introduction: Symptoms like syncope or palpitations frequently present a diagnostic challenge. An implantable loop recorder (ILR) is an important aid in the management of these patients. Methods: A retrospective study of patients that underwent ILR implantation from November 2007 to 2014. For each patient the indication for implantation, baseline characteristics, previous study, complications, recorded tracing and interventions were evaluated. Results: A total of 62 patients were included, 50% men, with a mean age of 62...
August 2016: Journal of Atrial Fibrillation
M Unterhuber, W Rauhe, P Sgobino, F Pescoller, M Manfrin, M Tomaino
Through a retrospective study concerning the experience of our center in patients affected by Neurally Mediated reflex Syncope (NMS) we wanted to verify not only the diagnostic yield of the Implantable Loop Recorder (ILR) but its possible placebo therapeutic effect. In the context of patients affected by a severe clinical presentation of NMS identified through a careful clinical evaluation, we selected those who followed a diagnostic iter using the ILR. We analysed 84 patients (39 male and 45 female, mean age 71 years), during the period 2009-2013...
August 2016: Journal of Atrial Fibrillation
M Tomaino, M Unterhuber, P Sgobino, F Pescoller, M Manfrin, W Rauhe
In this study we wanted to verify the diagnostic value of tilt table test (TTT) to predict the efficacy of cardiac pacing (PM) for preventing recurrences of neurally mediated reflex syncope (NMS) in patients with cardioinhibitory activity (CI) documented by implantable loop recorder (ILR). Among patients selected by ILR in the context of severe clinical presentation of NMS, we analysed those who underwent PM implantation. In this observational and retrospective study we wanted to verify the results of TTT in the groups of treated patients with and without recurrences...
April 2016: Journal of Atrial Fibrillation
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