Role of implantable loop recorder in evaluation of syncope – experience of our Center

█ Original article

DOI: 10.26430/CHUNGARICA.2023.53.3.234

Authors:
Harmati Gábor, Kovács Dávid, Kelemen Barbara, Faluközy József, Veress Gábor
Állami Szívkórház, I. sz. Aktív Kardiológiai Osztály, Balatonfüred

Levelezési cím:
Dr. Harmati Gábor, Állami Szívkórház, 8230 Balatonfüred, Gyógy tér 2. E-mail: harmatigabi@gmail.com

Summary
Syncope is a temporary loss of consciousness due to transient global cerebral hypoperfusion characterized by rapid onset, short duration, and complete spontaneous recovery. Identification of the exact cause of syncope is key to provide adequate treatment to patients, and several non-invasive and invasive diagnostic tools are available in clinics. Implantable loop recorder (ILR) plays a prominent role in the evaluation of syncope and allows continuous monitoring of patients for years (if necessary). ILR implantation has been available in our Heart Center since October 2013. Here we analysed our data and followed-up on patients receiving ILR between October 2013 and December 2020. Our aim was to evaluate the role of ILR in the diagnosis of syncope and compare our findings with literature data. In total, 133 ILR implantations have been performed by 3 trained cardiologists in our Heart Center during the study period. The mean age of patients was 63.9±13.1 years, and the mean follow-up duration was 22.7±16.9 months. ILR implantation occurred in 112 out of 133 (84.2%) patients following syncope, in 2 (1.2%) patients following palpitations, and in 19 (14.3%) patients following myocardial infarction. The origin of the syncope was identified in 64 (57.1%) patients with syncope, including sinus node dysfunction in 32 (28.6%), atrioventricular conduction abnormalities in 13 (11.6%), and bradyarrhythmia in 6 (5.4%) patients. Ventricular tachycardia was found in 2 patients. Atrial fibrillation and paroxysmal supraventricular tachycardia (PSVT) were newly diagnosed in 10 (8.9%) and 2 (1.5%) patients, respectively. Non-cardiac origin was revealed in 11 (9.8%) patients. The cause of syncope is yet to be determined in 48 (42.8%) patients. Based on the diagnosis obtained by ILR, 43 patients received a pacemaker, and 2 patients got an implantable cardioverter defibrillator (ICD). These data are consistent with global trends reported in the literature. In summary, we identified the cause of syncope in more than half of our patients using ILR. These data indicate that ILR implantation is an effective diagnostic tool in the evaluation of syncope. Moreover, earlier, and more frequently occurring implantation of ILR in patients with syncope may provide additional benefits.

ISSUE: CARDIOLOGIA HUNGARICA | 2023 | VOLUME 53, ISSUE 3

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