Validation of an Implantable Loop Recorder in Patients with Unexplained Syncope

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Background: Implantable loop recorders (ILRs) have recently become available in Japan. The clinical usefulness of ILRs was evaluated. Methods: Five patients with episodes of unexplained syncope were studied. After the ILR implantation, the patients were followed-up at 1 month, and every 2 months thereafter, to interrogate the devices. The QRS wave amplitudes during sinus rhythm were measured shortly after implantation and every visit with the patients in four different positions. Results: The mean initial QRS amplitudes were 0.8 mV in the supine position, 0.8 mV in the right lateral decubitus position, 0.6 mV in the left lateral decubitus position, and 0.9 mV in the sitting position. The amplitudes were consistent throughout the mean follow-up period of 8 months in all the patients. A total of 60 episodes were automatically recorded: 52 tachyarrhythmias, 6 asytoles, and 2 bradycardias. Tachyarrhythmias included 50 atrial fibrillations, one non-sustained ventricular tachycardia, and one T wave over-sensing. Asystoles included one R wave under-sensing episode. There were 4 active patient recordings: one was associated with atrial fibrillation and the others were not associated with arrhythmias. One patient was diagnosed with brady-tachycardia syndrome at 3 months and underwent a pacemaker implantation. Conclusions: Although two episodes of sensing errors were seen, the recording status was generally stable. ILRs were useful in one patient to establish a diagnosis.
日本不整脈学会の論文

Validation of an Implantable Loop Recorder in Patients with Unexplained Syncope

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