Usefulness of implantable Ioop recorder in patients with recurrent syncope of unknown origin

G. Pettinati, D. Melissano, F. De Santis, A. Marzo

Division of Cardiology, “F Ferrari” Hospital, Casarano (Italy)

3rd International Congress of the Mediterranean SOCIETY OF PACING  AND ELECTROPHISIOLOGY. (LISBONA 25 - 27 September 2003) Reprints from: Mediterranean Journal of Pacing and Electrophisyology. Volume 5, n.2, 2003

Implantable loop recorders (ILR), (Medtronic, Reveal) have recently become available for use in the evaluation of patients with recurrent syncope of unknown origin. Recent advances in loop recorder technology permit an oppor­tunity for long-term monitoring to provide a symptorn rhythm correlation in this population.

Aim of the studv 

was to assess the feasibility and diagnostic capacity of a insertable loop recorder trough long term ECG monitoring.

ILR as a little Pace Maker 61- 19 -  8 mm dimensions, weights 17 g., has 2 bipolar sensing electrodes 3.7 cm apart on the housing and is implanted in the thorax using local anaesthetic. On a period from 1998 to 2003 we implanted 10 patients. 6 F, 4 M, age range 18 - 72 y with recurrent uncxplained syncopal episodes 5±3! years and undergo many. and expensive non invasive investigation.

During a follow up 5±/3 months 9 patient assessed syncopal or pre-syncopal episodes recorded by Reveal device. 5 patients had tachyarrythmias (3 sustained STV 170/b!m, 2 AF with brady-tachy syndrome).  4 patients presented hradyarrhvthmias (2 complete AV block, i asystole by sinus carotid syndrome, 1 asystole by sick sinus syndrome). 3 paticnts with sustained STV was young females, mean age 20 years. All patients, with pharmacological and electrical therapy arc, now, asymptoinatic.

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