Article Text

Download PDFPDF
Heart rhythm disorders and pacemakers
The implantable loop recorder in children
  1. B Yeung1,
  2. K McLeod2
  1. 1
    Department of Surgery, NHS Greater Glasgow & Clyde, Glasgow Royal Infirmary, Glasgow, UK
  2. 2
    Department of Paediatric Cardiology, Yorkhill NHS Trust, Royal Hospital for Sick Children, Glasgow, UK
  1. Dr K McLeod, Department of Paediatric Cardiology, Yorkhill NHS Trust, Royal Hospital for Sick Children, Dalnair Street, Glasgow G3 8SJ, UK; karen.mcleod{at}yorkhill.scot.nhs.uk

Abstract

Objective: To evaluate use of the implantable loop recorder in children.

Setting: Royal Hospital for Sick Children, Glasgow, UK.

Method: Retrospective study of children who had an implantable loop recorder between September 1998 and October 2005.

Results: 38 devices were implanted in 34 children. Median age at implantation 11.3 years (range 1.8–17.6); median follow-up period 15 months (range 2–58). The main presenting complaint was syncope in 26 (76.5%), seizures in 6 (17.6%) and palpitations in 2 (5.9%). After implantation, 19 (55.9%) patients had symptom recurrence. Of these, 11 were shown to have sinus rhythm during symptoms and 8 had an abnormal ECG. Four patients had asystole >3 seconds and were diagnosed with reflex asystolic syncope; 2 had polymorphic ventricular tachycardia. One patient who already had a diagnosis of long QT syndrome was shown to have ventricular ectopy during symptoms and β-blockers were increased. One patient had transient complete heart block during symptoms but refused a pacemaker. In almost half the patients (44.1%), symptoms resolved after implantation. Complications requiring removal of the device occurred in 6 (15.8%) implants.

Conclusions: In children with syncope and palpitations, the implantable loop recorder appears to be an excellent method of effecting a “cure” in almost 50% of subjects. For those who remain symptomatic, it is successful in determining cardiac rhythm during symptoms, but the complication rate in children may be higher than that of adults.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

  • Competing interests: None.

  • See Editorial, p 832

Linked Articles