Implantable loop recorders identified the underlying rhythm during recurrent symptoms in 6 of 12 children (50%) with unexplained syncope over an average follow-up of 20 months.
Observational (n=12)
Does implantable loop recorder implantation improve the diagnosis of life-threatening arrhythmias in children with unexplained syncope?
Implantable loop recorders have a high diagnostic yield for detecting life-threatening arrhythmias in children with unexplained syncope.
BACKGROUND: Syncope is a frequent complaint in children and adolescents and may be a significant sign of serious pathology. Although patient history, family history, and physical examination are sufficient to reach a diagnosis in most cases of syncope, the cause of syncope still cannot be determined after initial investigation in one-third to half of all patients. The aim of this study was to evaluate the diagnostic yield of implantable loop recorder (ILR) in children with unexplained syncope. METHODS: A retrospective review was carried out of clinical data, indications, findings, and a final management strategy in patients who underwent ILR implantation. RESULTS: A total of 12 patients with a mean age of 9.4 ± 4.5 years underwent ILR (Reveal Plus; Medtronic) implantation. ILR implantation indication was syncope in all of the patients. Family history, routine cardiac assessment, including resting 12-lead electrocardiogram, transthoracic echocardiography, 24 h Holter recording, and event recorder findings, were normal with the exception of one patient with (previously corrected) tetralogy of Fallot. After an average of 20 months (range, 1-36 months), six patients developed symptoms. ILR memory showed torsades de pointes-ventricular fibrillation (n = 3), catecholaminergic polymorphic ventricular tachycardia (n = 1), asystole and ventricular tachycardia (n = 1), and normal sinus rhythm (n = 1). At the time of writing six patients were still in follow up with no symptoms after an average of 25.2 months. CONCLUSION: Implantable loop recorder plays an important role in the diagnosis of life-threatening arrhythmias in which syncope is otherwise unexplained. ILR implantation should be remembered in children whose symptoms are strongly correlated with rhythm disturbances.
Ergül et al. (Tue,) conducted a observational in Unexplained syncope (n=12). Implantable loop recorder (ILR) was evaluated on Diagnostic yield of implantable loop recorder. Implantable loop recorders identified the underlying rhythm during recurrent symptoms in 6 of 12 children (50%) with unexplained syncope over an average follow-up of 20 months.