title: The diagnostic yield from implantable loop recorders in children and young adults.
abstract: BACKGROUND
  Syncope and palpitations occur frequently in young patients. Noninvasive diagnostic testing may be inconclusive.
  
  
  OBJECTIVE
  To assess the diagnostic yield of implantable loop recorders in young patients.
  
  
  METHODS
  Thirty-three young patients underwent implantation of a loop recorder for long-term monitoring of cardiac rhythm, to establish symptom-rhythm correlation. They belonged to one of three subgroups: those with structurally normal heart, normal electrocardiogram at rest, and negative family history (n = 16); patients with structural heart disease and previous surgical repair (n = 11), and patients with proven or suspected primary electrical disease (n = 6). A combination of automatic and patient-activated recordings was used to monitor cardiac rhythm during symptomatic episodes.
  
  
  RESULTS
  There were no procedural complications. Diagnostic electrograms could be obtained in all patients. A high degree of symptom-rhythm correlation was established. In 8/33 patients, no recurrence of symptoms was observed either until end of battery life of the device (n = 4) or until last follow-up (n = 2). Specific cardiac therapy was required, based on rhythms recorded by the device in 15 patients (until last follow-up). This consisted of catheter ablation of a tachyarrhythmia (n = 7), pacemaker implantation or upgrade (n = 5) or ICD implantation (n = 5). In the remaining patients (n = 10), recurrence of symptoms was associated with a normal electrocardiogram, and in two of these patients a non-cardiac diagnosis was made.
  
  
  CONCLUSIONS
  In selected patients, the implantable loop recorder provides valuable diagnostic information to guide further therapy.
authors.affiliation: Department of paediatric cardiology, University Hospitals of Tuebingen and Cologne, Germany. n.sreeram@uni-koeln.de
authors.forename: N
authors.initials: N
authors.lastname: Sreeram
authors.forename: M
authors.initials: M
authors.lastname: Gass
authors.forename: C
authors.initials: C
authors.lastname: Apitz
authors.forename: G
authors.initials: G
authors.lastname: Ziemer
authors.forename: M
authors.initials: M
authors.lastname: Hofbeck
authors.forename: M
authors.initials: M
authors.lastname: Emmel
authors.forename: K
authors.initials: K
authors.lastname: Brockmeier
authors.forename: F
authors.initials: F
authors.lastname: Hitchcock
authors.forename: G
authors.initials: G
authors.lastname: Bennink
mesh_terms: D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D015716:Electrocardiography, Ambulatory / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007223:Infant; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D011379:Prognosis; D015203:Reproducibility of Results; D013997:Time Factors