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Europace Advance Access originally published online on October 26, 2007
Europace 2007 9(12):1196-1201; doi:10.1093/europace/eum239
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2007. For permissions please email: journals.permissions@oxfordjournals.org

SYNCOPE

Utility of in-hospital cardiac remote telemetry in patients with unexplained syncope

Juan Benezet-Mazuecos*, Borja Ibanez, Jose Manuel Rubio, Felipe Navarro, Edita Martín, Jose Romero and Jeronimo Farre

Department of Cardiology, Fundacion Jimenez Diaz-Capio, Universidad Autonoma de Madrid, Madrid, Spain

Aims: Cardiac remote telemetry (CR-TEL) is in wide use in cardiac units, but its diagnostic value in the setting of unexplained syncope is unknown.

Methods: One hundred and two consecutive patients (73 ± 14 years) arriving to the emergency department due to an unexplained syncope were admitted under CR-TEL. Heart rhythm was continuously monitored from a central station by trained nurses. Events included all causes of mortality and arrhythmias unnoticed on emergency department.

Results: Thirty patients (29.4%) presented events. There were no deaths during the time of monitoring (4.8 ± 2.7 days). Events requiring transfer to the coronary care units (CCU) occurred in 15 patients (14.7%), principally due to AV-block and extreme bradycardia. Cardiac remote telemetry was diagnostic in 18 patients (17.6%) in whom the arrhythmic event occurred simultaneously with the syncopal episode. Multivariate analysis showed that age ≥86 years (P < 0.01) and heart failure on admission (P < 0.04) were the strongest predictors of events. All transfers to the CCU were documented within the first 4 days. The best cut-off point as a threshold for CR-TEL monitoring time was 72 hours (sensitivity 73%, specificity 86%).

Conclusion: Cardiac remote telemetry appears to be a useful tool in the management of patients with unexplained syncope, especially in those older and presenting heart failure on admission.

Key Words: Syncope, Cardiac remote telemetry, Arrhythmia, Diagnosis

* Corresponding author. Servicio de Cardiología, Fundación Jiménez Díaz, Avenida Reyes Católicos 2. Madrid 28040, Spain. Tel: +34 91 550 48 80; fax: +34 91 549 70 33. E-mail address: jbenezet{at}yahoo.es

Manuscript submitted 17 July 2007. Accepted after revision 26 September 2007.


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