Incremental diagnostic yield of loop electrocardiographic recorders in unexplained syncope

https://doi.org/10.1016/0002-9149(90)90591-NGet rights and content

Abstract

The Holter monitor, the most frequently used diagnostic test in patients with syncope, is nondiagnostic in over 90% of cases. This study sought to determine the impact of a new noninvasive device, the cardiac loop electrocardiographic (ECG) recorder, after Holter monitoring in 57 patients with unexplained syncope. All patients underwent a standardized evaluation protocol and wore the monitor for up to 1 month. In 14 patients, loop recording definitively determined whether an arrhythmia was the cause of symptoms (diagnostic yield 25%; 95% confidence intervals 14 to 38%). Diagnoses included unsuspected ventricular tachycardia (1 patient), high grade atrioventricular block (2 patients), supraventricular tachycardia (1 patient), asystole or junctional bradycardia from neurally mediated syncope (3 patients) and normal cardiac rhythms (the remaining 7 patients). Follow-up of all patients diagnosed as having nonarrhythmic syncope by loop recording showed that none of these patients died suddenly. Cardiac loop ECG recording is an important new diagnostic test in patients with syncope unexplained by Holter monitoring.

References (25)

  • MD Silverstein et al.

    Patients with syncope admitted to medical intensive care units

    JAMA

    (1982)
  • HE Gendelman et al.

    Syncope in a general hospital patient population

    NY State Med J

    (1983)
  • Cited by (230)

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    This study was supported in part by grants from the Charles A. Dana Foundation, the Duke Women's Auxiliary, and grants HL24920, HL40392 and the Biomedical Research Grant Program (S07RR05405) from the National Institutes of Health, Bethesda, Maryland. This study was performed through the General Clinical Research Center (M-01, RR-30) at Duke University Medical Center. Monitoring equipment for this study was provided by Instromedix, Inc., Beaverton, Oregon. Research costs for patients undergoing monitoring with the King of Hearts recorder were also provided by Instromedix, Inc.

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    Dr. Linzer's current address: Division of General Medicine, New England Medical Center, Boston, Massachusetts 02111.

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