open access

Vol 66, No 1 (2008)
Other
Published online: 2008-02-04
Submitted: 2012-12-28
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Original article
High incidence of tachyarrhythmias detected by an implantable loop recorder in patients with unexplained syncope

Christiana Schernthaner, Franz Danmayr, Johann Altenberger, Maximilian Pichler, Bernhard Strohmer
Kardiol Pol 2008;66(1):37-44.

open access

Vol 66, No 1 (2008)
Other
Published online: 2008-02-04
Submitted: 2012-12-28

Abstract


Background:

Syncope is a complex clinical syndrome that may be challenging with respect to a definite diagnosis. The implantable loop recorder (ILR) is a useful tool to define but also to exclude an arrhythmic aetiology.
Aim:

To investigate the causes of recurrent syncope or near-syncope with respect to underlying arrhythmias in non-selected consecutive patients monitored with an ILR.
Methods:

A retrospective study was conducted including 55 patients (34 men, 21 women; age 60±19 years) with unexplained syncope who received an ILR for prolonged monitoring at our institution between April 1998 and October 2006.
Results:

Forty (73%) patients had a recurrence of syncope or near-syncope. Structural heart disease was present in 18 (33%) patients, 4 of them having an ejection fraction <35%. An arrhythmia was detected as the cause of syncope in 25 (46%) patients. The ILR was successful in establishing a symptom-rhythm correlation in 63%. The mean follow-up period from implantation to occurrence of the detected arrhythmias was 9&plusmn;8 months. Bradyarrhythmias were recorded in 12 (22%) patients, whereas tachyarrhythmias were found in 13 (24%) patients. Narrow QRS tachycardia was the underlying arrhythmia in 6 patients and wide QRS tachycardia in 7 patients. A pacemaker was implanted in all 12 patients with bradyarrhythmias. Implantable cardioverter defibrillator (ICD) therapy was indicated in 6 patients with adjunctive catheter ablation in 3 of them. Four patients presenting with paroxysmal supraventricular tachycardia were treated with radiofrequency catheter ablation.
Conclusion:

The ILR helped efficaciously to determine the correct diagnosis and appropriate treatment of recurrent syncope. A considerably high proportion of tachyarrhythmias was detected in this non-selected consecutive population. The majority of patients with tachyarrhythmic syncope required defibrillator implantation and/or radiofrequency ablation.

Abstract


Background:

Syncope is a complex clinical syndrome that may be challenging with respect to a definite diagnosis. The implantable loop recorder (ILR) is a useful tool to define but also to exclude an arrhythmic aetiology.
Aim:

To investigate the causes of recurrent syncope or near-syncope with respect to underlying arrhythmias in non-selected consecutive patients monitored with an ILR.
Methods:

A retrospective study was conducted including 55 patients (34 men, 21 women; age 60&plusmn;19 years) with unexplained syncope who received an ILR for prolonged monitoring at our institution between April 1998 and October 2006.
Results:

Forty (73%) patients had a recurrence of syncope or near-syncope. Structural heart disease was present in 18 (33%) patients, 4 of them having an ejection fraction <35%. An arrhythmia was detected as the cause of syncope in 25 (46%) patients. The ILR was successful in establishing a symptom-rhythm correlation in 63%. The mean follow-up period from implantation to occurrence of the detected arrhythmias was 9&plusmn;8 months. Bradyarrhythmias were recorded in 12 (22%) patients, whereas tachyarrhythmias were found in 13 (24%) patients. Narrow QRS tachycardia was the underlying arrhythmia in 6 patients and wide QRS tachycardia in 7 patients. A pacemaker was implanted in all 12 patients with bradyarrhythmias. Implantable cardioverter defibrillator (ICD) therapy was indicated in 6 patients with adjunctive catheter ablation in 3 of them. Four patients presenting with paroxysmal supraventricular tachycardia were treated with radiofrequency catheter ablation.
Conclusion:

The ILR helped efficaciously to determine the correct diagnosis and appropriate treatment of recurrent syncope. A considerably high proportion of tachyarrhythmias was detected in this non-selected consecutive population. The majority of patients with tachyarrhythmic syncope required defibrillator implantation and/or radiofrequency ablation.
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Keywords

syncope; implantable loop recorder; tachyarrhythmia

About this article
Title


Original article
High incidence of tachyarrhythmias detected by an implantable loop recorder in patients with unexplained syncope

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 66, No 1 (2008)

Pages

37-44

Published online

2008-02-04

Bibliographic record

Kardiol Pol 2008;66(1):37-44.

Keywords

syncope
implantable loop recorder
tachyarrhythmia

Authors

Christiana Schernthaner
Franz Danmayr
Johann Altenberger
Maximilian Pichler
Bernhard Strohmer

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