Abstract

Since its introduction 15 years ago, the implantable loop recorder (ILR) has become the investigative tool of choice in recurrent unexplained syncope following negative initial investigations. This is based on very few randomised controlled clinical trials and modestly sized observational studies. Further controlled data are required to inform clinical practice with attention focused on empowering ILR-guided diagnosis, establishing the optimal timing of ILR use in syncope and embracing new technological advancements.