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Observational Study
. 2021 Sep;26(5):e12864.
doi: 10.1111/anec.12864. Epub 2021 Jun 7.

Diagnostic value of implantable loop recorders in patients with unexplained syncope or palpitations

Nikola N Radovanović  1 , Siniša U Pavlović  1   2 , Bratislav Kirćanski  1   2 , Nemanja Branković  1 , Nikola Vujadinović  1 , Vojislav Sajić  1 , Ana Milašinović  1 , Vesna Bisenić  1 , Mirjana Živković  1 , Goran Milašinović  1   2
Affiliations
Observational Study

Diagnostic value of implantable loop recorders in patients with unexplained syncope or palpitations

Nikola N Radovanović et al. Ann Noninvasive Electrocardiol. 2021 Sep.

Abstract

Background: The implantable loop recorder (ILR) is a small cardiac rhythm-monitoring device. Our aim was to determine ILR diagnostic value in patients with unexplained syncope, presyncope, or palpitations suggesting cardiac arrhythmias.

Methods: This has been a retrospective, observational, single-center study. We included 181 patients in whom ILR was implanted at the Clinical Center of Serbia between January 2006 and July 2019. An event was marked as diagnostic if it led to a diagnosis and ILR was considered diagnostic if it verified or excluded an arrhythmia as the cause of syncope or palpitations.

Results: The mean age was 51.8 ± 17.8 years and 94 (51.9%) were male. The mean follow-up period was 20.2 ± 15.8 months. ILR was diagnostic in 98 patients (54.1%). There was no significant difference in diagnostic value of ILR in regard to the baseline patients' characteristics. The mean time to occurrence of the diagnostic event was 11.1 ± 9.6 months. The time to occurrence of a diagnostic event did not differ significantly between patients who underwent basic as compared to extended diagnostics before ILR implantation.

Conclusions: ILR was able to achieve an etiological diagnosis in 54.1% of patients with unexplained syncope, presyncope, or palpitations suggesting cardiac arrhythmias. In a subgroup of patients with recurrent palpitations, ILR was significantly less diagnostic than in patients with syncope or presyncope. ILR should be implanted beforehand in syncope evaluation process.

Keywords: arrhythmia; implantable loop recorder; palpitations; syncope.

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Conflict of interest statement

None.

Figures

FIGURE 1
FIGURE 1
The Kaplan‐Meier estimates of time to diagnostic event in patients who underwent basic vs. extended diagnostics before implantable loop recorder implantation
See this image and copyright information in PMC

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