[Long-term follow-up after implantable loop recorder in patients with syncope: results of a French general hospital survey].
OBJECTIVE
Despite recent advances in diagnostic procedures, syncope remains unexplained in 15 to 35% of patients. If implantable loop recorder is a validated diagnostic tool for unexplained syncope, results of this strategy are largely issued from randomized studies. We lack the results of surveys. The aim of this study was to report a single center experience with implantable loop recorders, in patients with unexplained syncope.


RESULTS
A device (Medtronic Reveal DX or XT) was implanted in 31 patients between January 2009 and January 2012. During a mean follow-up of 10.5±8.5 months, loop recording definitively determined that an arrhythmia was the cause of symptoms in 10 patients (32%). Fourteen patients (45%) experienced syncope or pre-syncope. In eight of the 14 patients with syncope, during follow-up, no arrhythmic diagnosis could be made (one patient has been diagnosed as presenting epilepsy and seven as having hypotensive vasovagal syncope). In six patients, the ILR showed an arrhythmic aetiology. Four other patients presented an abnormal ILR result without symptoms. Diagnosis included sinusal arrest in four patients, bradycardia in one patient, advanced atrioventricular block in two patients, ventricular arrythmias in two patients, and supraventricular tachycardia of 180/min in one patient. Therapy was instituted in all patients, in whom an arrhythmic cause was found except one who refused the therapy (six pacemaker, two implantable cardioverter-defibrillator implantations, and one cryoablation of atrioventricular nodal reentrant tachycardia confirmed by an invasive exploration).


CONCLUSIONS
In this survey, implantable loop recorder implantation led to the diagnosis of an arrhythmic cause in 32% of patients and excluded an arrhythmic cause in 26% of patient with a mean follow-up of 10.5 months.
Unité de rythmologie, GHI Le Raincy-Montfermeil, 10, rue du Général-Leclerc, 93370 Montfermeil, France.
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H
Salih
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F
Monsel
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J
Sergent
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W
Amara
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D054537:Atrioventricular Block / Q000150:complications / Q000628:therapy; D001919:Bradycardia / Q000150:complications / Q000628:therapy; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D005602:France; D019538:Health Care Surveys; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012804:Sick Sinus Syndrome / Q000150:complications / Q000628:therapy; D013575:Syncope / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D019462:Syncope, Vasovagal / Q000150:complications / Q000628:therapy; D013617:Tachycardia, Supraventricular / Q000150:complications / Q000628:therapy; D017180:Tachycardia, Ventricular / Q000150:complications / Q000628:therapy; D016896:Treatment Outcome