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Implantable loop recorder syncope

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https://www.readbyqxmd.com/read/27909534/efficacy-and-safety-of-implantable-loop-recorder-experience-of-a-center
#1
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
https://www.readbyqxmd.com/read/27909530/implantable-loop-recorder-diagnostic-yield-and-possible-therapeutic-effect-in-patients-with-neurally-mediated-reflex-syncope
#2
Unterhuber M, Rauhe W, Sgobino P, Pescoller F, Manfrin M, Tomaino M
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
https://www.readbyqxmd.com/read/27909502/combined-diagnostic-yield-of-tilt-table-test-and-implantable-loop-recorder-to-identify-patients-affected-by-severe-clinical-presentation-of-neurally-mediated-reflex-syncope-who-could-respond-to-cardiac-pacing
#3
Tomaino M, Unterhuber M, Sgobino P, Pescoller F, Manfrin M, Rauhe W
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
https://www.readbyqxmd.com/read/27885230/the-implantation-of-a-loop-recorder-to-detect-the-cause-of-pre-syncope-in-an-85-year-old-man
#4
Yasuhisa Iriki, Naoya Oketani, Mitsuru Ohishi
The patient was an-85-year-old man with hypertension and hyperlipidemia. The patient had a history of faintness on standing. He visited our hospital after experiencing chest oppression and pre-syncope in 2015. Brain magnetic resonance imaging and echocardiography did not detect any structural brain or heart disease. Ischemic heart disease was suspected based on the myocardial scintigraphy findings, but coronary angiography revealed no unusual findings. Holter electrocardiography did not reveal the reason for his symptoms...
2016: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/27873022/current-rare-indications-and-future-directions-for-implantable-loop-recorders
#5
Simon Wechselberger, Christopher Piorkowski, Matthias Pohl
The scope of application for implantable loop recorders has shifted away from the evaluation of unclear palpitations and syncope episodes to more complex conditions. This article focuses on rare indications of growing importance such as rhythm monitoring after ablation of atrial fibrillation or after cryptogenic stroke. Furthermore, forthcoming applications in various clinical settings are described, e. g., arrhythmia detection after myocardial infarction, after catheter-based valve interventions, in heart failure, and in cardiomyopathies...
November 21, 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27848030/-implantable-loop-recorder-biomonitor%C3%A2-2-biotronik
#6
Thorsten Lewalter, Clemens Jilek
The implantable loop recorder BioMonitor 2 is available with an emphasis on syncope and one on detection of atrial tachycardias. The BioMonitor 2 can be easily implanted. The BioMonitor 2 pilot study showed a high and over time stable signal and the telemetric performance was above average.
November 15, 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27844191/-indications-for-implantable-loop-recorders-in-patients-with-channelopathies-and-ventricular-tachycardias
#7
Julia Köbe, Kristina Wasmer, Florian Reinke, Lars Eckardt
Implantable loop recorders (ILR) do not play a pivotal role in the current guidelines on ventricular arrhythmias except in identifying rhythm-symptom correlations if ventricular arrhythmias are assumed. Before a decision for a pure diagnostic implantable device is made, a thorough arrhythmic risk assessment is of major importance due to the potential lethal outcome of ventricular arrhythmias. Nevertheless, some clinical circumstances exist where long-term monitoring by an ILR may add significant information in electrical heart diseases, in patients with ventricular arrhythmias, or structural heart diseases and a potential risk of ventricular arrhythmias...
November 14, 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27836945/cochrane-corner-implantable-loop-recorder-versus-conventional-workup-for-unexplained-recurrent-syncope
#8
EDITORIAL
Monica Solbiati, Giovanni Casazza, Franca Dipaola, Robert S Sheldon, Giorgio Costantino
No abstract text is available yet for this article.
December 1, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27812742/-implantable-loop-recorders-in-the-diagnosis-of-syncope
#9
B M Kaess, J R Ehrlich
In syncope patients, it is essential to make the right diagnosis with respect to underlying etiology. Cardiac (arrhythmic and structural) syncopal episodes carry untoward prognostic implication compared with reflex syncope. While rhythm-symptom correlation of a spontaneous syncopal episode is key to making the correct diagnosis, in case of unclear syncope the early implantation of a loop recorder leads to faster, more efficacious, and more cost-effective diagnosis. This review article summarizes the current data regarding diagnostic accuracy and clinical role of implantable loop recorders...
November 3, 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27690674/loop-recorders-for-syncope-evaluation-what-is-the-evidence
#10
Christopher C Cheung, Andrew D Krahn
Implantable loop recorders (ILRs) have become an important pillar in the diagnostic work-up of patients with unexplained syncope. Areas covered: The modern ILR is minimally-invasive and provides an extended-duration of monitoring with high diagnostic yield. These insertable cardiac monitors (ICMs) enable prolonged monitoring that extends the opportunity for symptom-rhythm correlation from days-weeks to years, with associated incremental diagnostic yield. Over the years, observational studies and randomized trials have supported a unique role for ILRs in the assessment of recurrent or high-risk unexplained syncope...
November 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27651841/the-current-indication-for-pacemaker-in-patients-with-cardioinhibitory-vasovagal-syncope
#11
Rose Mary Ferreira Lisboa da Silva
The most frequent cause of syncope is vasovagal reflex. It is associated with worse quality of life, depression, fatigue and physical injury. Recurrence of vasovagal syncope is an aggravating, reaching the rate of 69%. Initial step and pharmacological treatment may not work, especially in patients with recurrent syncope without prodrome. These patients can present cardioinhibitory response with asystole. Studies were designed to analyses the effectiveness of pacemaker for prevention of syncope. In this review, nonrandomized clinical trials, open-label randomized, double-blind randomized, placebo-controlled, and studies based on tilt test or Implantable Loop Recorder findings will be discussed...
2016: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/27639455/mechanism-of-syncope-without-prodromes-with-normal-heart-and-normal-electrocardiogram
#12
Michele Brignole, Regis Guieu, Marco Tomaino, Matteo Iori, Andrea Ungar, Cristina Bertolone, Matthias Unterhuber, Nicola Bottoni, Francesca Tesi, Jean Claude Deharo
BACKGROUND: "Unexplained syncope, no prodromes, and normal heart" has been described as a distinct clinical and biological entity. OBJECTIVE: The purpose of this study was to assess the mechanism of syncope. METHODS: In this prospective multicenter study, 58 patients presenting with unexplained syncope, no prodromes, and a normal heart received an implantable loop recorder (ILR) and were followed up until a diagnosis was established. Their outcomes were compared with those of 389 patients affected by reflex syncope with prodromes who received an ILR...
September 14, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27617093/holter-monitoring-and-loop-recorders-from-research-to-clinical-practice
#13
Alessio Galli, Francesco Ambrosini, Federico Lombardi
Holter monitors are tools of proven efficacy in diagnosing and monitoring cardiac arrhythmias. Despite the fact their use is widely prescribed by general practitioners, little is known about their evolving role in the management of patients with cryptogenic stroke, paroxysmal atrial fibrillation, unexplained recurrent syncope and risk stratification in implantable cardioverter defibrillator or pacemaker candidates. New Holter monitoring technologies and loop recorders allow prolonged monitoring of heart rhythm for periods from a few days to several months, making it possible to detect infrequent arrhythmias in patients of all ages...
August 2016: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/27539163/catecholaminergic-polymorphic-ventricular-tachycardia-associated-with-sinus-node-dysfunction-and-junctional-rhythm-case-report-and-literature-review
#14
Natale Daniele Brunetti, Pier Luigi Pellegrino, Girolamo D'Arienzo, Rafel Sai, Luigi Ziccardi, Francesco Santoro, Antonio Gaglione, Matteo Di Biase
We report the case of a 38-year-old woman with history of syncope and polymorphic ventricular tachycardia; tachycardia was inducible at exercise stress test, not at electrophysiologic study. Phases of QT prolongation were found at ambulatory electrocardiogram monitoring. The woman came to our attention for periodic control of implantable loop recorder. Rest electrocardiogram at admission unexpectedly showed sinus bradycardia, junctional rhythm, and ventricular premature beats. Furthermore, loop recorder control revealed a short run of bidirectional tachycardia, not associated with syncope...
July 28, 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27231019/implantable-loop-recorder-monitoring-for-refining-management-of-children-with-inherited-arrhythmia-syndromes
#15
Jennifer N Avari Silva, Burt I Bromberg, Fredrick K Emge, Tammy M Bowman, George F Van Hare
BACKGROUND: Implantable loop recorders (ILRs) are conventionally utilized to elucidate the mechanism of atypical syncope. The objective of this study was to assess the impact of these devices on management of pediatric patients with known or suspected inherited arrhythmia syndromes. METHODS AND RESULTS: A retrospective chart review was undertaken of all pediatric patients with known or suspected inherited arrhythmia syndromes in whom an ILR was implanted from 2008 to 2015...
June 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27194540/differential-effect-of-ganglionic-plexi-ablation-in-a-patient-with-neurally-mediated-syncope-and-intermittent-atrioventricular-block
#16
Masato Fukunaga, Dan Wichterle, Petr Peichl, Bashar Aldhoon, Robert Čihák, Josef Kautzner
AIMS: In patients with severe neurally mediated syncope (NMS), radiofrequency catheter ablation (RFA) of ganglionic plexi (GP) has been proposed as a new therapeutic approach. Cardio-inhibitory response during NMS is usually related to the sinoatrial (SA) and less frequently to atrioventricular (AV) node. Differential effect of GP ablation on SA and AV node is poorly understood. METHODS AND RESULTS: We report a case of a 35-year-old female with frequent symptomatic episodes of advanced AV block treated by anatomically guided RFA at empirical sites of GPs...
May 18, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27172926/long-term-follow-up-of-ictal-asystole-in-temporal-lobe-epilepsy-is-permanent-pacemaker-therapy-needed
#17
Ritsuko Kohno, Haruhiko Abe, Naoki Akamatsu, David G Benditt
BACKGROUND: Ictal asystole (IA) is an infrequent complication of temporal lobe epilepsy (TLE), but one that may cause transient loss of consciousness (T-LOC) similar to reflex syncope (particularly the vasovagal faint). Although IA-triggered T-LOC is relatively rare, its recognition is therapeutically important. However, while the need for anti-epileptic drugs (AeDs) is broadly accepted, cardiac pacing in IA is controversial. This study aimed to evaluate the need for cardiac pacing in the follow-up of IA patients being treated with AeDs...
August 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27092427/implantable-loop-recorder-versus-conventional-diagnostic-workup-for-unexplained-recurrent-syncope
#18
REVIEW
Monica Solbiati, Giorgio Costantino, Giovanni Casazza, Franca Dipaola, Andrea Galli, Raffaello Furlan, Nicola Montano, Robert Sheldon
BACKGROUND: The most recent syncope guideline recommends that implantable loop recorders (ILRs) are implanted in the early phase of evaluation of people with recurrent syncope of uncertain origin in the absence of high-risk criteria, and in high-risk patients after a negative evaluation. Observational and case-control studies have shown that loop recorders lead to earlier diagnosis and reduce the rate of unexplained syncopes, justifying their use in clinical practice. However, only randomised clinical trials with an emphasis on a primary outcome of specific ILR-guided diagnosis and therapy, rather than simply electrocardiogram (ECG) diagnosis, might change clinical practice...
2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27062386/miniaturized-implantable-loop-recorder-in-small-patients-an-effective-approach-to-the-evaluation-of-subjects-at-risk-of-sudden-death
#19
Silvia Placidi, Fabrizio Drago, Maddalena Milioni, Letizia Verticelli, Ilaria Tamburri, Massimo Stefano Silvetti, Corrado DI Mambro, Daniela Righi, Fabrizio Gimigliano, Mario Salvatore Russo, Rosalinda Palmieri, Romolo Remoli, Lorenzo Maria Santucci, Alberto Eugenio Tozzi
BACKGROUND: The etiological diagnosis of syncope and/or palpitations in children is often challenging. However, when noninvasive conventional examinations are inconclusive, the subcutaneous miniaturized implantable loop recorder (ILR) is recommended. The aim of our study was to evaluate the efficacy of miniaturized cardiac implantable devices in the early diagnosis of arrhythmias in children ≤6 years. METHODS: From March 2014 to May 2015, 21 patients (median age 5 years) underwent implantation of miniaturized ILR at our Institution after a complete cardiac work up...
July 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27022459/tilt-table-test-today-state-of-the-art
#20
REVIEW
Nicholay Teodorovich, Moshe Swissa
A tilt table test (TTT) is an inexpensive, noninvasive tool for the differential diagnosis of syncope and orthostatic intolerance and has good diagnostic yield. The autonomic system malfunction which underlines the reflex syncope is manifested as either hypotension or bradycardia, while an orthostatic challenge is applied. The timing of the response to the orthostatic challenge, as well as the predominant component of the response help to differentiate between various forms of neurocardiogenic syncope, orthostatic hypotension and non-cardiovascular conditions (e...
March 26, 2016: World Journal of Cardiology
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