Skip Navigation



European Heart Journal Advance Access published online on November 28, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi602
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
27/3/351    most recent
ehi602v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Farwell, D. J.
Right arrow Articles by Sulke, N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Farwell, D. J.
Right arrow Articles by Sulke, N.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received November 29, 2004
Revised September 21, 2005
Accepted September 29, 2005

Clinical research

The clinical impact of implantable loop recorders in patients with syncope

David J. Farwell 1, Nick Freemantle 1, and Neil Sulke 1 *

1 Department of Cardiology, Eastbourne District General Hospital, King's Drive, Eastbourne, East Sussex, UK; Department of Primary Care and General Practice, University of Birmingham, UK

* To whom correspondence should be addressed.
Neil Sulke, E-mail: djfarwell{at}bigfoot.com


  Abstract

Aims Implantable loop recorders (ILR) provide an opportunity to record ECG data from a spontaneous syncopal event. We conducted a randomized study to investigate the impact of the Reveal Plus ILR on an unselected population of patients with recurrent syncope. Initial follow-up (at least 6 months) did not demonstrate a reduction in syncopal events or an improvement in quality of life. We report the planned extension of follow-up to 18 months.

Methods and results All patients presenting acutely with recurrent unexplained syncope over a 16-month period, following a basic clinical work-up, were randomized to receive the ILR or conventional investigation and management. A total of 421 patients presented, 201 were eligible, median age 74, (IQ range 61-81) 54% female, with median syncopes 3 (IQ range 2-6). Median follow-up 17 months (IQ range 9-23). 42 (43%) of ILR patients and 8 (6%) of conventional patients received an ECG diagnosis (hazard ratio 6.53, 95% CI 3.73-11.4, P < 0.001). Time to second syncope was significantly longer for ILR patients, although of borderline significance (P = 0.04). A greater variety of diagnoses and treatments were seen in ILR patients. ILR patients had fewer post-randomization investigations and fewer days in hospital; however, cost savings were not statistically significant. There was improved quality of life in the ILR group (visual analogue scales, P = 0.03) for general wellbeing. Overall mortality was 12% with no difference between the two groups.

Conclusion Investigation by the ILR significantly increases the diagnostic rate and ECG directed treatments in a typical unselected syncopal population. Long-term follow-up has demonstrated a significant subsequent reduction in syncopal events with improved quality of life.

Keywords: Syncope; Implantable loop recorder; Cost effectiveness.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Eur Heart JHome page
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]

Home page
 EuropaceHome page
A. J. Turley, M. M. Tynan, and C. J. Plummer
Time to manual activation of implantable loop recorders--implications for programming recording period: a 10-year single-centre experience
Europace, October 1, 2009; 11(10): 1359 - 1361.
[Abstract] [Full Text] [PDF]

Home page
 EuropaceHome page
Task Force members, M. Brignole, P. Vardas, E. Hoffman, H. Huikuri, A. Moya, R. Ricci, N. Sulke, W. Wieling, EHRA Scientific Documents Committee, et al.
Indications for the use of diagnostic implantable and external ECG loop recorders
Europace, May 1, 2009; 11(5): 671 - 687.
[Full Text] [PDF]

Home page
 EuropaceHome page
D. Kenny, S. Chakrabarti, A. Ranasinghe, A. Chambers, R. Martin, and G. Stuart
Single-centre use of implantable loop recorders in patients with congenital heart disease
Europace, March 1, 2009; 11(3): 303 - 307.
[Abstract] [Full Text] [PDF]

Home page
 ESC Textbook of Cardiovascular MedicineHome page
M. Brignole, J.-J. Blanc, R. Sutton, and A. Moya
CHAPTER 26 Syncope
ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
R. H Pass and L. Liberman
The implantable loop recorder in children: searching for indications
Heart, July 1, 2008; 94(7): 832 - 833.
[Full Text] [PDF]

Home page
 HeartHome page
T Pezawas, G Stix, J Kastner, B Schneider, M Wolzt, and H Schmidinger
Implantable loop recorder in unexplained syncope: classification, mechanism, transient loss of consciousness and role of major depressive disorder in patients with and without structural heart disease
Heart, April 1, 2008; 94(4): e17 - e17.
[Abstract] [Full Text] [PDF]

Home page
 Evid. Based Med.Home page
Other articles noted
Evid. Based Med., August 1, 2006; 11(4): 127 - 128.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.