title: [Diagnostic yield of the implantable loop recorder to detect the mechanism of syncope--a single center long term experience of a tertiary care center].
abstract: OBJECTIVE
  The aim of this study was to investigate the usefulness in providing diagnostic information about syncope by implantation of a loop recorder (ILR).
  
  
  RESULTS
  The study population consisted of 48 consecutive patients (23 male, 25 female, mean age 42 +/- 17) with unexplained syncope who presented between 1998 and 2002 and underwent extensive cardiological screening and were followed with an implantable loop recorder (Reveal or Reveal Plus). The mean follow-up duration was 9 +/- 6 months. During this follow-up in 17 (35%) patients syncope recurred. Arrhythmia correlating with syncope was documented in 15 (88%) of these patients, in 2 (12%) patients an arrhythmia could be excluded. Of these 15 patients with arrhythmogenic cause of syncope 5 (33%) patients revealed higher degree AV-Block, 7 (47%) patients sinus bradycardia or sinus pauses, 4 (27%) due to sick sinus syndrome and 3 (20%) due to neurally mediated syncope, 3 (20%) patients had atrial tachycardias or atrial fibrillation with rapid AV-conduction. As a result of ILR findings 12 pacemakers were implanted and 2 radiofrequency ablations were performed.
  
  
  CONCLUSIONS
  The ILR is a valuable and effective tool to establish an arrhythmic cause for unexplained syncope. In these cases they have an impact on subsequent clinical decision making. ILR can also be useful in ruling out arrhythmias as cause of syncope and presyncope.
authors.affiliation: Abteilung für Kardiologie, Universitätsspital Zürich. corinna.brunckhorst@usz.ch
authors.forename: C B
authors.initials: CB
authors.lastname: Brunckhorst
authors.forename: K
authors.initials: K
authors.lastname: Lemola
authors.forename: J
authors.initials: J
authors.lastname: Holzmeister
authors.forename: Ch
authors.initials: Ch
authors.lastname: Scharf
authors.forename: S
authors.initials: S
authors.lastname: Altwegg
authors.forename: Ch
authors.initials: Ch
authors.lastname: Binggeli
authors.forename: J P
authors.initials: JP
authors.lastname: Hellermann
authors.forename: F
authors.initials: F
authors.lastname: Enseleit
authors.forename: F
authors.initials: F
authors.lastname: Duru
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy; D001919:Bradycardia / Q000150:complications / Q000175:diagnosis; D017115:Catheter Ablation; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory / Q000295:instrumentation*; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000150:complications / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012804:Sick Sinus Syndrome / Q000150:complications / Q000175:diagnosis; D013575:Syncope / Q000209:etiology*; D013610:Tachycardia / Q000150:complications / Q000175:diagnosis; D013997:Time Factors