Introduction: Symptoms like syncope or palpitations frequently present a diagnostic challenge. An implantable loop recorder (ILR) is an important aid in the management of these patients.
Methods: A retrospective study of patients that underwent ILR implantation from November 2007 to 2014. For each patient the indication for implantation, baseline characteristics, previous study, complications, recorded tracing and interventions were evaluated.
Results: A total of 62 patients were included, 50% men, with a mean age of 62,5±18,8 years old. Previously to ILR implantation 88.7% of patients had performed Holter, 17.7% external events recorder, 33.9% Tilt test and 29% an electrophysiological study. The implantation indications were recurrent syncope in 90.3%, palpitations 8.1% and ischemic stroke in one patient. Mean follow-up time was 17,1±16,3 months. Symptoms were reported in 66.1% of the patients, 46,8% of those yielding a diagnostic finding. In all cases of palpitation complaints atrial fibrillation (AF) was diagnosed. In patients with syncope atrioventricular conduction disturbance was demonstrated in 19.6%, sinus node dysfunction in 16.1%, paroxysmal supra-ventricular tachycardia 7.1% and AF in 1.8%. These finding resulted in 19 pacemaker and 1 CRT-D implantation, introduction of anticoagulation in 5 patients, and one ablation of accessory pathway. There were no major complications.
Conclusion: ILR proved to be safe and efficient. It has enabled the identification or exclusion of serious rhythm disturbances in more than half of patients and provided a targeted therapeutic intervention.
Credits: Inês Silveira; Maria João Sousa; Nuno Antunes; Vânia Silva; Carla Roque; António Pinheiro-Vieira; Vítor Lagarto; António Hipólito-Reis; André Luz; Severo Torres