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Europace 2002 4(2):211-213; doi:10.1053/eupc.2002.0229
© 2002 by European Society of Cardiology
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CASE REPORTS

Implantable loop recorder undersensing mimicking complete heart block

S. I. Chrysostomakis, E. N. Simantirakis, M. E. Marketou and P. E. Vardas

Cardiology Department, University Hospital of Heraklion Crete, Greece

The newer implantable loop recorders recently introduced (Reveal Plus, Medtronic Inc, Minneapolis, MN, U.S.A.), equipped with auto activation capabilities, are expected to expand our diagnostic abilities in the investigation of syncopal episodes. The case presented here is that of a man with pre-syncopal and syncopal episodes, without organic heart disease, in whom the device was auto-activated due to undersensing and the recorded strip imitated complete heart block. Increased attention should be given by the interpreter of the device's recordings to avoid false positive diagnoses that might lead to serious therapeutic actions.

Key Words: Implantable loop recorder, undersensing, complete heart block, syncope

Correspondence: Prof. P. E. Vardas, MD, PhD (London), FESC, FACC, Cardiology Department, Heraklion University Hospital, P.O. Box 1352 Stavrakia, Heraklion, Crete, Greece. E-mail cardio{at}med.uoc.gr

[1] Krahn AD, Klein GJ, Yee R, Takle-Newhouse T, Norris C. Use of an extended monitoring strategy in patients with problematic syncope. Reveal Investigators. Circulation 1999; 99: 406–410.[Abstract/Free Full Text]

[2] Kapoor WN. Evaluation and management of the patient with syncope. JAMA 1992; 268: 2553–2560.[Abstract/Free Full Text]

[3] Martin GJ, Adams SL, Martin HG, Matthews J, Zull D, Scanlon PJ. Prospective evaluation of syncope. Ann Emerg Med 1984; 13: 499–504.[CrossRef][Web of Science][Medline]

[4] Simantirakis EN, Chrysostomakis SI, Manios EG, Vardas PE. Insertable loop recorder in unmasking the cause of syncope. Pacing Clin Electrophysiol 2000; 23: 1573–1575.[Medline]

[5] Zellerhoff C, Himmrich E, Nebeling D, Przibille O, Nowak B, Liebrich A. How can we identify the best implantation site for an ECG event recorder? Pacing Clin Electrophysiol 2000; 23: 1545–1549.[Medline]


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