Implantable loop recorders in patients with heart disease: comparison between patients with and without syncope
Objective Patients with heart disease are at increased risk for sudden cardiac death. Guidelines recommend an implantable loop recorder (ILR) for symptomatic patients when symptoms are sporadic and possibly arrhythmia-related. In clinical practice, an ILR is mainly used in patients with unexplained...
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| Format: | Article |
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BMJ Publishing Group
2021-12-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/8/2/e001748.full |
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| author | Jolien W Roos-Hesselink Michelle Michels Tamas Szili-torok Judith M A Verhagen Rohit E Bhagwandien Sing-Chien Yap DOMINIC THEUNS Amira Assaf Rafi Sakhi |
| author_facet | Jolien W Roos-Hesselink Michelle Michels Tamas Szili-torok Judith M A Verhagen Rohit E Bhagwandien Sing-Chien Yap DOMINIC THEUNS Amira Assaf Rafi Sakhi |
| author_sort | Jolien W Roos-Hesselink |
| collection | DOAJ |
| description | Objective Patients with heart disease are at increased risk for sudden cardiac death. Guidelines recommend an implantable loop recorder (ILR) for symptomatic patients when symptoms are sporadic and possibly arrhythmia-related. In clinical practice, an ILR is mainly used in patients with unexplained syncope. We aimed to compare the clinical value of an ILR in patients with heart disease and a history of syncope versus those with non-syncopal symptoms.Methods In this observational single-centre study, we included symptomatic patients with heart disease who received an ILR. The primary endpoint was an actionable event which was defined as an arrhythmic event leading to a change in clinical management. The secondary endpoint was an event leading to device implantation.Results One hundred and twenty patients (mean age 47±17 years, 49% men) were included. The underlying disease substrate was inherited cardiomyopathy (31%), congenital heart disease (28%), channelopathy (23%) and other (18%). Group A consisted of 43 patients with prior syncope and group B consisted of 77 patients with palpitations and/or near-syncope. The median follow-up duration was 19 months (IQR 8–36). The 3-year cumulative event rate was similar between groups with regard to the primary endpoint (38% vs 39% for group A and B, respectively, logrank p=0.54). There was also no difference in the 3-year cumulative rate of device implantation (21% vs 13% for group A and B, respectively, logrank p=0.65).Conclusion In symptomatic patients with heart disease, there is no difference in the yield of an ILR in patients presenting with or without syncope. |
| format | Article |
| id | doaj-art-fd2c37e41fd4467eb9ef5494a3b0b12e |
| institution | OA Journals |
| issn | 2053-3624 |
| language | English |
| publishDate | 2021-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj-art-fd2c37e41fd4467eb9ef5494a3b0b12e2025-08-20T02:13:53ZengBMJ Publishing GroupOpen Heart2053-36242021-12-018210.1136/openhrt-2021-001748Implantable loop recorders in patients with heart disease: comparison between patients with and without syncopeJolien W Roos-Hesselink0Michelle Michels1Tamas Szili-torok2Judith M A Verhagen3Rohit E Bhagwandien4Sing-Chien Yap5DOMINIC THEUNS6Amira Assaf7Rafi Sakhi8Department of Cardiology, Erasmus Medical Center, Rotterdam, The NetherlandsDepartment of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The NetherlandsDepartment of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The NetherlandsDepartment of Clinical Genetics, University Medical Center Rotterdam, Rotterdam, The NetherlandsDepartment of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The NetherlandsDepartment of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The NetherlandsDepartment of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The NetherlandsDepartment of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The NetherlandsDepartment of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The NetherlandsObjective Patients with heart disease are at increased risk for sudden cardiac death. Guidelines recommend an implantable loop recorder (ILR) for symptomatic patients when symptoms are sporadic and possibly arrhythmia-related. In clinical practice, an ILR is mainly used in patients with unexplained syncope. We aimed to compare the clinical value of an ILR in patients with heart disease and a history of syncope versus those with non-syncopal symptoms.Methods In this observational single-centre study, we included symptomatic patients with heart disease who received an ILR. The primary endpoint was an actionable event which was defined as an arrhythmic event leading to a change in clinical management. The secondary endpoint was an event leading to device implantation.Results One hundred and twenty patients (mean age 47±17 years, 49% men) were included. The underlying disease substrate was inherited cardiomyopathy (31%), congenital heart disease (28%), channelopathy (23%) and other (18%). Group A consisted of 43 patients with prior syncope and group B consisted of 77 patients with palpitations and/or near-syncope. The median follow-up duration was 19 months (IQR 8–36). The 3-year cumulative event rate was similar between groups with regard to the primary endpoint (38% vs 39% for group A and B, respectively, logrank p=0.54). There was also no difference in the 3-year cumulative rate of device implantation (21% vs 13% for group A and B, respectively, logrank p=0.65).Conclusion In symptomatic patients with heart disease, there is no difference in the yield of an ILR in patients presenting with or without syncope.https://openheart.bmj.com/content/8/2/e001748.full |
| spellingShingle | Jolien W Roos-Hesselink Michelle Michels Tamas Szili-torok Judith M A Verhagen Rohit E Bhagwandien Sing-Chien Yap DOMINIC THEUNS Amira Assaf Rafi Sakhi Implantable loop recorders in patients with heart disease: comparison between patients with and without syncope Open Heart |
| title | Implantable loop recorders in patients with heart disease: comparison between patients with and without syncope |
| title_full | Implantable loop recorders in patients with heart disease: comparison between patients with and without syncope |
| title_fullStr | Implantable loop recorders in patients with heart disease: comparison between patients with and without syncope |
| title_full_unstemmed | Implantable loop recorders in patients with heart disease: comparison between patients with and without syncope |
| title_short | Implantable loop recorders in patients with heart disease: comparison between patients with and without syncope |
| title_sort | implantable loop recorders in patients with heart disease comparison between patients with and without syncope |
| url | https://openheart.bmj.com/content/8/2/e001748.full |
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