Utility of event loop recorders for the management of arrhythmias in young ambulatory patients

Abstract

We evaluated the diagnostic yield of event loop recorders in ambulatory patients referred for palpitations, dizziness or syncopal events and in whom a previous Holter recording was not diagnostic. A total of 96 patients were studied, 50 (52%) were men and 46 (48%) were women with a mean age of 37+/-10 years. Mean duration of the recording was 5.2+/-2.3 days. During the recording period, 24 of the 96 patients (25%) remained asymptomatic. Automatic recordings revealed significant arrhythmias in four (16.7%) patients, which included two (8.3%) cases of atrial fibrillation, one (4.2%) non-sustained ventricular tachycardia (VT) and one (4.2%) second degree atrio-ventricular (AV) block. The manual function of the recorder was used by 72 (75%) patients while they were symptomatic. Palpitations were the most common symptom, which corresponded most frequently to normal sinus rhythm (43.1%), followed by sinus tachycardia (16.7%). An arrhythmic substrate was found in 29 (40.3%) patients, including 13 (18.1%) with isolated ectopic beats of supraventricular and/or ventricular origin, 14 (19.4%) with supraventricular tachycardia (SVT) and 2 (2.8%) with second degree AV block. The data of our study showed that the ambulatory use of an event loop recorder in young patients during a mean period of 5 days was highly useful to elucidate the potential cause of their symptoms. The particular use of the manually triggered function during symptoms allowed to establish a clear correlation between symptoms and arrhythmic events including sinus tachycardia in 75% of patients.