Key result
The implantable loop recorder provided a final etiologic diagnosis in 33.8% of patients in real-world clinical practice, independent of baseline characteristics.
Why the study?
Does implantable loop recorder (ILR) implantation allow an etiologic diagnosis in patients with paroxysmal conditions potentially related to arrhythmias?
Observational (n=743)
Yes
Does implantable loop recorder (ILR) implantation allow an etiologic diagnosis in patients with paroxysmal conditions potentially related to arrhythmias?
In real-world clinical practice, implantable loop recorders provide a definitive etiologic diagnosis in approximately one-third of patients, most commonly identifying bradyarrhythmia as the cause of syncope.
Registry data describe real-world ILR use; leaves open optimal selection and diagnostic impact.
BACKGROUND: The implantable loop recorder (ILR) is a useful tool for diagnosing paroxysmal conditions potentially related to arrhythmias. Most investigations have focused on selected clinical studies or high-volume centers. The aim of this study was to evaluate the indications and outcomes of the ILR in real clinical practice. METHODS AND RESULTS: This was a prospective, multicenter registry of patients undergoing ILR implantation for clinical indications (April 2006-December 2008). Clinical characteristics (symptoms, arrhythmias, treatments) were recorded in a database. Follow-up data at 1 year or after the occurrence of the first episode were also recorded. Total enrollment: 743 patients (male, 413, 55.6%; 64.9 ± 16 years); 228 (30.7%) had structural heart disease (SHD), and 183 (24.6%), bundle branch block (BBB). Recurrent syncope (76.4%) was the most common indication for implantation. Complete follow-up was obtained for 680 patients (91.5%). Three hundred and twenty-five patients (48%) presented 414 events, with a final diagnosis in 230 patients (70.8% of patients with events; 33.1% of patients with follow-up). Syncope secondary to bradyarrhythmia was the most frequent diagnosis. Similar rates of final diagnoses were noted in subgroups of SHD, BBB and normal heart. Regarding the cause of implantation, higher event rates were registered among patients with recurrent syncope. CONCLUSIONS: One-third of patients obtained a final diagnosis with the ILR, independent of the baseline characteristics. Only the cause of implantation provided different rates of final diagnosis.
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Lacunza et al. (2013) conducted an observational in Syncope and other paroxysmal conditions (n=743). Implantable loop recorder was evaluated on Final etiologic diagnosis. The implantable loop recorder provided a final etiologic diagnosis in 33.8% of patients in real-world clinical practice, independent of baseline characteristics.
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