Key result
Implantable loop recorder detects transient 6:1 AV block in recurrent syncope, guiding successful pacemaker placement.
Case Report (n=1)
No
This case demonstrates the importance of prolonged rhythm monitoring with an implantable loop recorder to diagnose elusive high-grade AV block in patients with recurrent unexplained syncope.
May support ILR in refractory syncope after normal testing; leaves open need for prospective validation.
We present a case of a 55-year-old man with a prior history of syncope and vertigo due to high-grade atrioventricular (AV) block despite initial negative tests. The patient underwent multiple diagnostic evaluations, including a normal echocardiogram, myocardial perfusion imaging, Holter monitoring, and electrocardiography. As his symptoms continued to persist, an implantable loop recorder (Confirm Rx™; Abbott, Sylmar, USA) was inserted subcutaneously, which revealed transient 6:1 high-grade AV block and bradycardia. Despite normal initial investigations, his persistent symptoms and documented conduction abnormality prompted pacemaker (Abbott, Sylmar, USA) placement. This case highlights the importance of detailed electrophysiologic assessment and close monitoring in patients with recurrent unexplained syncope and high-grade AV block, even with prior normal testing.
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Mesaris et al. (2025) conducted a case report in High-grade atrioventricular block (n=1). Implantable loop recorder and pacemaker placement was evaluated on Detection of arrhythmia and symptom resolution. An implantable loop recorder identified a transient 6:1 high-grade atrioventricular block in a patient with recurrent syncope despite normal initial testing, leading to successful pacemaker placement.
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