title: Implantable loop recorders for assessment of syncope: increased diagnostic yield and less adverse outcomes with the latest generation devices.
abstract: OBJECTIVE
  Aim of the study was to compare the diagnostic yield of implantable loop recorders (ILR) of two successive generations for the assessment of syncope.
  
  
  METHODS
  Data on patients who had undergone ILR implantation for unexplained syncope in four Italian public hospitals were retrospectively acquired from the Medtronic Clinical Service database. After implantation, routine follow-up examinations were performed every 90 days, while urgent examinations were carried out in the event of syncope recurrence.
  
  
  RESULTS
  The following findings were regarded as diagnostic: ECG documentation of a syncope recurrence; documentation of any of the arrhythmias listed by the current guidelines as diagnostic findings even if asymptomatic. Between November 2002 and March 2010, 107 patients received an ILR (40 Medtronic Reveal® Plus; 67 Medtronic Reveal® DX/XT) and underwent at least one follow-up examination. Diagnoses were made in 7 (17.5%) and 24 (35.8%) (P=0.043) patients, with a median time of 228 and 65 days, respectively. Three (42.9%) and 21 (87.5%) (P=0.029) diagnoses were based on automatically detected events, while adverse outcomes occurred in 6 and in 1 (P=0.01) patients, respectively.
  
  
  CONCLUSIONS
  Our results show that the new-generation device offer a higher diagnostic yield, mainly as a result of its improved automatic detection function, and is associated with fewer adverse outcomes.
authors.affiliation: Cardiology Division S. Giovanni di Dio Hospital, Florence, Italy - angelobartoletti@alice.it.
authors.forename: A
authors.initials: A
authors.lastname: Bartoletti
authors.forename: P
authors.initials: P
authors.lastname: Bocconcelli
authors.forename: T
authors.initials: T
authors.lastname: De Santo
authors.forename: A
authors.initials: A
authors.lastname: Ghidini Ottonelli
authors.forename: S
authors.initials: S
authors.lastname: Giuli
authors.forename: R
authors.initials: R
authors.lastname: Massa
authors.forename: C
authors.initials: C
authors.lastname: Svetlich
authors.forename: G
authors.initials: G
authors.lastname: Tarsi
authors.forename: G
authors.initials: G
authors.lastname: Corbucci
authors.forename: F
authors.initials: F
authors.lastname: Tronconi
authors.forename: E
authors.initials: E
authors.lastname: Vitale
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D015716:Electrocardiography, Ambulatory / Q000295:instrumentation*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D013575:Syncope / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D013997:Time Factors