Key result
Implantable loop recorders provide extended-duration monitoring with high diagnostic yield for the assessment of recurrent or high-risk unexplained syncope.
Why the study?
What is the evidence for the use of implantable loop recorders compared to conventional management or external loop recorders in the evaluation of unexplained syncope?
What is the evidence for the use of implantable loop recorders compared to conventional management or external loop recorders in the evaluation of unexplained syncope?
This review highlights the high diagnostic yield of ILRs for unexplained syncope, supporting their early use in recurrent or high-risk cases as recommended by current guidelines.
Answers are grounded in this paper and cite their sources.
May support ILR consideration in recurrent syncope; leaves open randomized comparisons to external monitoring.
INTRODUCTION: Implantable loop recorders (ILRs) have become an important pillar in the diagnostic work-up of patients with unexplained syncope. Areas covered: The modern ILR is minimally-invasive and provides an extended-duration of monitoring with high diagnostic yield. These insertable cardiac monitors (ICMs) enable prolonged monitoring that extends the opportunity for symptom-rhythm correlation from days-weeks to years, with associated incremental diagnostic yield. Over the years, observational studies and randomized trials have supported a unique role for ILRs in the assessment of recurrent or high-risk unexplained syncope. Furthermore, ILRs have been used in the elderly, in children, patients with overt heart disease, and patients with conduction block with varying success. The current guidelines recommend ILRs in the early phase of evaluation in recurrent syncope, and as part of the comprehensive evaluation of high-risk patients with syncope. Expert commentary: In this review, we discuss the evidence surrounding ILRs, including comparison studies with 'conventional' management and the external loop recorder.
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Cheung et al. (2016) conducted a review in Unexplained syncope. Implantable loop recorders (ILRs) vs. Conventional management and external loop recorders was evaluated. Implantable loop recorders provide extended-duration monitoring with high diagnostic yield for the assessment of recurrent or high-risk unexplained syncope.
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