Aim: to test the Implantable Loop Recorder (ILR) in syncopal and non-syncopal transient loss of consciousness (TLoC) and in detecting atrial fibrillation (AF) in cryptogenic stroke.
Methods: 182 patients were implanted between January 2003 and May 2014. 81 (45%) syncope; 3 (1.6%) pseudo-syncope; 32 (18%) epileptics; 35 (19.2%) unexplained falls; 6 (3.3%) patients with syncope/fall; 5 (2.7%) suspected AF; 20 (11%) cryptogenic stroke.
Results: the mean age was 70±14.2 years. After a follow-up of 19 ±16 months, 109 patients (59.9%) relapsed. Asystole was detected in 51.9% of the syncope, in 100% of the epileptics, in 53.9% of the fallers, in 20% of the syncope/falls and in 33.3% of the strokes. AF was confirmed in 80% of the suspected cases, in 66.7% of the strokes, in 40% of those with syncope and falls. Diagnosis was made in 70.4% of the syncope, in 59.4% of the epileptics, in 74.3% of the fallers, in 100% of the syncope/falls, in 66.7% of the pseudo-syncope, in 50% of the strokes and in the 100% of the suspected AF. No arrhythmia was recorded in 64 patients, in 49 of these the monitoring is ongoing. Pacemaker was implanted in 22.2% of the syncope, in 18.8% of the epileptics, in the 20% of the suspected AF. Oral anticoagulation was started in 60% of AF patients, in 20% of the strokes, in 16.7% of the syncope and falls.
Conclusions: ILR is useful in detecting arrhythmias both in high risk patients and in the TLoC diagnostic pathway.