Implantable loop recorders detect tachyarrhythmias in symptomatic patients with negative electrophysiological studies.
BACKGROUND
Implantable loop recorders (ILR) are a valuable tool in the investigation of syncope and compare favourably with non-invasive and intracardiac electrophysiological assessment of bradycardia. They are known to detect tachyarrhythmias but have not been shown to add to the diagnostic yield of electrophysiological testing in symptomatic patients.


METHODS
We prospectively studied the first 41 patients (aged 48+/-19 years) in whom ILR were used at our institution after negative electrophysiological studies (EPS). All patients were symptomatic with palpitations (11), syncope (22) or both (8). Nine patients had known structural heart disease (two ischaemic, four cardiomyopathy, two valvular and one congenital). Patients were assessed according to demographic factors, symptoms and investigations. Loop recordings were analysed and assessed according to conventional criteria.


RESULTS
Among 41 patients in whom electrophysiological studies had failed to demonstrate arrhythmias, six were found to have clinically significant tachyarrhythmias (four ventricular and two supraventricular).


CONCLUSIONS
ILR diagnose prognostically significant tachyarrhythmias in symptomatic patients with negative electrophysiological studies.
Paisey
John R
JR
Wessex Cardiothoracic Centre, Southampton University Hospitals, Southampton SO16 6YD, UK. johnpaisey@doctors.org.uk
Yue
Arthur M
AM
Treacher
Kenneth
K
Roberts
Paul R
PR
Morgan
John M
JM
D000328:Adult; D000368:Aged; D001282:Atrial Flutter / Q000175:diagnosis; D017147:Defibrillators, Implantable; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D004567:Electrodes, Implanted; D022062:Electrophysiologic Techniques, Cardiac / Q000295:instrumentation*; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013610:Tachycardia / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D018667:Tilt-Table Test; D006113:United Kingdom