title: [Implantable "loop recorder"--a new diagnostic tool for syncope of unknown cause].
abstract: BACKGROUND
  The implantable loop recorder (ILR) is a new diagnostic tool in cardiology for establishing the causes of unexplained syncope in patients where standard conventional tests, invasive tests included, have failed. The device is a diagnostic "pacemaker," surgically implanted underneath the skin of the chest, with leads attached to the case of the device, not requiring endovenous lead implantation. Heart rhythm is monitored continuously on the basis of an endless loop, up to a maximum period of 14 months. Recording is carried out either by applying an outside activator whenever symptoms occur, or automatically, according to a pre-set algorithm for bradycardia, tachycardia, and/or asystolic detection.
  
  
  OBJECTIVE
  The aim of this study was to present this new diagnostic method as well as our first experiences with its implementation.
  
  
  METHODS
  We followed 5 patients (3 male, 2 female, mean age: 46.4 +/- 19) who had ILRs ("Reveal Plus," Medtronic Inc., USA) implanted at our centre, over a period of 14 months (7.6 +/- 5.5), concentrating on their clinical course, symptom occurrence, and electronically monitored heart rhythm at the time of ILR auto activation and/or recordings triggered by outside activation whenever a patient's symptoms were discernible.
  
  
  RESULTS
  In three patients, the ILR revealed syncope aetiology by documenting heart rhythm at the time of its occurrence. In one patient, involving a lethal outcome, the ILR was not explanted, so that the rhythm at the time of the fatal syncope, although assumed, remained undocumented. In one, most recently implanted patient, follow-up is still in progress.
  
  
  CONCLUSIONS
  The implantable loop recorder represents an important innovation and a step forward in establishing the causes of recurrent syncope, which cannot be determined by standard invasive and non-invasive testing.
authors.forename: Goran
authors.initials: G
authors.lastname: Milasinović
authors.forename: Mirjana
authors.initials: M
authors.lastname: Zivković
authors.forename: Velibor
authors.initials: V
authors.lastname: Jovanović
authors.forename: Vera
authors.initials: V
authors.lastname: Jelić
authors.forename: Dragutin
authors.initials: D
authors.lastname: Savić
authors.forename: Sinisa U
authors.initials: SU
authors.lastname: Pavlović
authors.forename: Zarko
authors.initials: Z
authors.lastname: Calović
mesh_terms: D000328:Adult; D015716:Electrocardiography, Ambulatory / Q000295:instrumentation*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013575:Syncope / Q000175:diagnosis* / Q000209:etiology