[Syncope and a negative electrophysiological study. The usefulness of an implantable Holter monitor for the diagnosis of ventricular arrhythmias].
Currently the insertable loop recorder is usually indicated when the patient has recurrent syncopes and conventional Holter and electrophysiological testing have been negative. We report the case of a patient with dilated cardiomyopathy, admitted to our hospital due to a single episode of syncope. After performing conventional diagnostic procedures, including continuous electrocardiographic monitoring for 48 hours, 24-hour Holter and electrophysiological study, no abnormalities were detected. Therefore, a insertable loop recorder was implanted, which was activated by the patient one month later after a pre-syncopal situation. The Holter reading evidenced self-limited monomorphic ventricular tachycardia, confirming the arrhythmic origin of the syncope. In patients with severe structural heart disease, in whom syncope can be caused by a malignant ventricular arrhythmia, the insertable loop recorder can be indicated in a single episode of syncope when the electrophysiological study is negative.
Belchí Navarro
J
J
Unidad de Arritmias, Hospital General Universitario, Valencia.
Quesada Dorador
A
A
Atienza Fernández
F
F
Villalba Caballero
S J
SJ
Roda Nicolás
J
J
de Velasco Ramí
J A
JA
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D015716:Electrocardiography, Ambulatory / Q000295:instrumentation*; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D012008:Recurrence; D013575:Syncope / Q000175:diagnosis* / Q000209:etiology