The implantable loop recorder in children.
OBJECTIVE
To evaluate use of the implantable loop recorder in children.


METHODS
Royal Hospital for Sick Children, Glasgow, UK.


METHODS
Retrospective study of children who had an implantable loop recorder between September 1998 and October 2005.


RESULTS
38 devices were implanted in 34 children. Median age at implantation 11.3 years (range 1.8-17.6); median follow-up period 15 months (range 2-58). The main presenting complaint was syncope in 26 (76.5%), seizures in 6 (17.6%) and palpitations in 2 (5.9%). After implantation, 19 (55.9%) patients had symptom recurrence. Of these, 11 were shown to have sinus rhythm during symptoms and 8 had an abnormal ECG. Four patients had asystole >3 seconds and were diagnosed with reflex asystolic syncope; 2 had polymorphic ventricular tachycardia. One patient who already had a diagnosis of long QT syndrome was shown to have ventricular ectopy during symptoms and beta-blockers were increased. One patient had transient complete heart block during symptoms but refused a pacemaker. In almost half the patients (44.1%), symptoms resolved after implantation. Complications requiring removal of the device occurred in 6 (15.8%) implants.


CONCLUSIONS
In children with syncope and palpitations, the implantable loop recorder appears to be an excellent method of effecting a "cure" in almost 50% of subjects. For those who remain symptomatic, it is successful in determining cardiac rhythm during symptoms, but the complication rate in children may be higher than that of adults.
Department of Surgery, NHS Greater Glasgow & Clyde, Glasgow Royal Infirmary, Glasgow, UK.
B
B
Yeung
K
K
McLeod
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D020878:Device Removal; D015716:Electrocardiography, Ambulatory / Q000009:adverse effects / Q000295:instrumentation*; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D019736:Prostheses and Implants / Q000009:adverse effects; D012008:Recurrence; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology; D013575:Syncope / Q000209:etiology*; D016896:Treatment Outcome