Use of an implantable loop recorder to increase the diagnostic yield in unexplained syncope: results from the PICTURE registry
Standard
Use of an implantable loop recorder to increase the diagnostic yield in unexplained syncope: results from the PICTURE registry. / Edvardsson, Nils; Frykman, Viveka; van Mechelen, Rob; Mitro, Peter; Mohii-Oskarsson, Afsaneh; Pasquié, Jean-Luc; Ramanna, Hemanth; Schwertfeger, Frank; Ventura, Rodolfo; Voulgaraki, Despina; Garutti, Claudio; Stolt, Pelle; Linker, Nicholas J; PICTURE Study Group.
in: EUROPACE, Jahrgang 13, Nr. 2, 02.2011, S. 262-269.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Use of an implantable loop recorder to increase the diagnostic yield in unexplained syncope: results from the PICTURE registry
AU - Edvardsson, Nils
AU - Frykman, Viveka
AU - van Mechelen, Rob
AU - Mitro, Peter
AU - Mohii-Oskarsson, Afsaneh
AU - Pasquié, Jean-Luc
AU - Ramanna, Hemanth
AU - Schwertfeger, Frank
AU - Ventura, Rodolfo
AU - Voulgaraki, Despina
AU - Garutti, Claudio
AU - Stolt, Pelle
AU - Linker, Nicholas J
AU - PICTURE Study Group
PY - 2011/2
Y1 - 2011/2
N2 - AIMS: To collect information on the use of the Reveal implantable loop recorder (ILR) in the patient care pathway and to investigate its effectiveness in the diagnosis of unexplained recurrent syncope in everyday clinical practice.METHODS AND RESULTS: Prospective, multicentre, observational study conducted in 2006-2009 in 10 European countries and Israel. Eligible patients had recurrent unexplained syncope or pre-syncope. Subjects received a Reveal Plus, DX or XT. Follow up was until the first recurrence of a syncopal event leading to a diagnosis or for ≥1 year. In the course of the study, patients were evaluated by an average of three different specialists for management of their syncope and underwent a median of 13 tests (range 9-20). Significant physical trauma had been experienced in association with a syncopal episode by 36% of patients. Average follow-up time after ILR implant was 10±6 months. Follow-up visit data were available for 570 subjects. The percentages of patients with recurrence of syncope were 19, 26, and 36% after 3, 6, and 12 months, respectively. Of 218 events within the study, ILR-guided diagnosis was obtained in 170 cases (78%), of which 128 (75%) were cardiac.CONCLUSION: A large number of diagnostic tests were undertaken in patients with unexplained syncope without providing conclusive data. In contrast, the ILR revealed or contributed to establishing the mechanism of syncope in the vast majority of patients. The findings support the recommendation in current guidelines that an ILR should be implanted early rather than late in the evaluation of unexplained syncope.
AB - AIMS: To collect information on the use of the Reveal implantable loop recorder (ILR) in the patient care pathway and to investigate its effectiveness in the diagnosis of unexplained recurrent syncope in everyday clinical practice.METHODS AND RESULTS: Prospective, multicentre, observational study conducted in 2006-2009 in 10 European countries and Israel. Eligible patients had recurrent unexplained syncope or pre-syncope. Subjects received a Reveal Plus, DX or XT. Follow up was until the first recurrence of a syncopal event leading to a diagnosis or for ≥1 year. In the course of the study, patients were evaluated by an average of three different specialists for management of their syncope and underwent a median of 13 tests (range 9-20). Significant physical trauma had been experienced in association with a syncopal episode by 36% of patients. Average follow-up time after ILR implant was 10±6 months. Follow-up visit data were available for 570 subjects. The percentages of patients with recurrence of syncope were 19, 26, and 36% after 3, 6, and 12 months, respectively. Of 218 events within the study, ILR-guided diagnosis was obtained in 170 cases (78%), of which 128 (75%) were cardiac.CONCLUSION: A large number of diagnostic tests were undertaken in patients with unexplained syncope without providing conclusive data. In contrast, the ILR revealed or contributed to establishing the mechanism of syncope in the vast majority of patients. The findings support the recommendation in current guidelines that an ILR should be implanted early rather than late in the evaluation of unexplained syncope.
KW - Adult
KW - Aged
KW - Arrhythmias, Cardiac/complications
KW - Diagnostic Tests, Routine
KW - Electrocardiography, Ambulatory/instrumentation
KW - Electrodes, Implanted
KW - Europe
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Israel
KW - Male
KW - Middle Aged
KW - Monitoring, Physiologic/instrumentation
KW - Practice Guidelines as Topic
KW - Prospective Studies
KW - Recurrence
KW - Registries
KW - Retrospective Studies
KW - Syncope/epidemiology
U2 - 10.1093/europace/euq418
DO - 10.1093/europace/euq418
M3 - SCORING: Journal article
C2 - 21097478
VL - 13
SP - 262
EP - 269
JO - EUROPACE
JF - EUROPACE
SN - 1099-5129
IS - 2
ER -