<p>Objective Patients with heart disease are at increased risk for sudden cardiac death. Guidelines recommend an implantable loop recorder (ILR) for symptomatic patients when symptoms are sporadic and possibly arrhythmia-related. In clinical practice, an ILR is mainly used in patients with unexplained syncope. We aimed to compare the clinical value of an ILR in patients with heart disease and a history of syncope versus those with non-syncopal symptoms. Methods In this observational single-centre study, we included symptomatic patients with heart disease who received an ILR. The primary endpoint was an actionable event which was defined as an arrhythmic event leading to a change in clinical management. The secondary endpoint was an event leading to device implantation. Results One hundred and twenty patients (mean age 47±17 years, 49% men) were included. The underlying disease substrate was inherited cardiomyopathy (31%), congenital heart disease (28%), channelopathy (23%) and other (18%). Group A consisted of 43 patients with prior syncope and group B consisted of 77 patients with palpitations and/or near-syncope. The median follow-up duration was 19 months (IQR 8-36). The 3-year cumulative event rate was similar between groups with regard to the primary endpoint (38% vs 39% for group A and B, respectively, logrank p=0.54). There was also no difference in the 3-year cumulative rate of device implantation (21% vs 13% for group A and B, respectively, logrank p=0.65). Conclusion In symptomatic patients with heart disease, there is no difference in the yield of an ILR in patients presenting with or without syncope.</p>

doi.org/10.1136/openhrt-2021-001748, hdl.handle.net/1765/136192
Open Heart
Erasmus MC: University Medical Center Rotterdam

A. (Amira) Assaf, R. (Rafi) Sakhi, M. (Michelle) Michels, J.W. (Jolien) Roos - Hesselink, J.M.A. (Judith) Verhagen, R.E. (Rohit) Bhagwandien, … S.C. (Sing) Yap. (2021). Implantable loop recorders in patients with heart disease. Open Heart, 8(2). doi:10.1136/openhrt-2021-001748