Europace Advance Access published online on March 5, 2008
Europace, doi:10.1093/europace/eun039
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Implantable loop recorder for recurrent syncope: influence of cardiac conduction abnormalities showing up on resting electrocardiogram and of underlying cardiac disease on follow-up developments
1 Service de cardiologie B et laboratoire d'electrophysiologie cardiaque, Pôle Cœur Vaisseaux Thorax et Hémostase, Centre Hospitalier Universitaire Trousseau, 37044 Routes de Loches, Tours, Indre et Loire, France; 2 Cardiologie Department, Centre Hospitalier Universitaire Trousseau, 37044 Routes de Loches, Tours, Indre et Loire, France; 3 Université François-Rabelais, 37032 Tours, France
Aims: The implantable loop recorder is a useful diagnostic tool in dealing with recurrent syncope in patients. We tested to determine the influence of cardiac conduction abnormalities that turn up on resting electrocardiogram (ECG) and the impact of underlying cardiac disease on developments during follow-up.
Methods and results: Ninety-five consecutive patients received an implantable loop recorder to monitor recurrent syncope (n = 4.9±3.8) of unknown aetiology after cardiac investigations, including an electrophysiological study. Resting ECG was abnormal, suggesting an arrhythmic syncope, in 29 (30.5%) patients, while 21 (22.1%) patients had an underlying cardiac disease. During an average follow-up period of 10.2±5.2 months, 43 (45.2%) patients developed a new syncope associated in 27 of them (62.8%) with an arrhythmic event. Syncope was no more frequent in the subgroup of patients with cardiac conduction abnormalities on resting ECG, while the frequency of arrhythmic events was similar whether or not the ECG was normal. In the subgroup of patients with cardiac disease with normal left ventricular ejection fraction, the occurrence of syncope was less frequent, and the number of arrhythmic events was no greater in these patients.
Conclusion: Implantable loop recorder is a useful diagnostic tool for recurrent syncope of unknown aetiology.
Key Words: Syncope, Implantable loop recorder, Bundle branch block, Cardiac disease, Atrioventricular block, Sinus arrest
* Corresponding author. Tel: +33 2 47 47 46 50; fax: +33 2 47 47 59 19. E-mail address: d.babuty{at}chu-tours.fr
Manuscript submitted 22 October 2007. Accepted after revision 2 February 2008.
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  Developed in collaboration with, European Heart Rhythm Association (EHRA), Heart Failure Association (HFA), and Heart Rhythm Society (HRS), Endorsed by the following societies, European Society of Emergency Medicine (EuSEM), European Federation of Internal Medicine (EFIM), European Union Geriatric Medicine Society (EUGMS), American Geriatrics Society (AGS), European Neurological Society (ENS), et al. Guidelines for the diagnosis and management of syncope (version 2009): The Task Force for the Diagnosis and Management of Syncope of the European Society of Cardiology (ESC) Eur. Heart J., November 1, 2009; 30(21): 2631 - 2671. [Full Text] [PDF]
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