Diagnostic yield of the implantable loop recorder in octogenarians.

BACKGROUND/OBJECTIVES: Syncope in octogenarians represents an important problem in terms of comorbidity, quality of life and substantial medical costs, resulting from studies and treatments. An implantable loop ecorder (ILR) may improve diagnostic performance. The objective of the study was to evaluate the results of the ILR in a population of octogenarians. DESIGN: Prospective registry of patients receiving an implantable loop recorder in 40 Spanish centers. PARTICIPANTS: 128 octogenarians implanted with a device for clinical evaluation of syncope. METHODS: Prospective registry recording the incidence of new symptoms or device activations within the first year after the implant, the incidence of new diagnosis and treatments, and an evaluation of the safety of this strategy in this population. Dedicated database for the registry. RESULTS: Forty-two patients (33% of the population) obtained a final etiological diagnosis of the syncope, which led to a specific treatment in 39 (31%) patients. No differences regarding the presence of conduction disturbances or structural heart disease were found in this population. A mortality of 4% was recorded during follow-up. CONCLUSION: The implantable loop recorder seems to be an effective and safe tool in the management of syncope in the octogenarian population.

Aneurisma coronario tras angioplastia con balón recubierto de paclitaxel / Coronary aneurysm after paclitaxel-eluting balloon angioplasty

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Implantable loop recorder allows an etiologic diagnosis in one-third of patients. Results of the Spanish reveal registry.

BACKGROUND: The implantable loop recorder (ILR) is a useful tool for diagnosing paroxysmal conditions potentially related to arrhythmias. Most investigations have focused on selected clinical studies or high-volume centers. The aim of this study was to evaluate the indications and outcomes of the ILR in real clinical practice. METHODS AND RESULTS: This was a prospective, multicenter registry of patients undergoing ILR implantation for clinical indications (April 2006-December 2008). Clinical characteristics (symptoms, arrhythmias, treatments) were recorded in a database. Follow-up data at 1 year or after the occurrence of the first episode were also recorded. Total enrollment: 743 patients (male, 413, 55.6%; 64.9 ± 16 years); 228 (30.7%) had structural heart disease (SHD), and 183 (24.6%), bundle branch block (BBB). Recurrent syncope (76.4%) was the most common indication for implantation. Complete follow-up was obtained for 680 patients (91.5%). Three hundred and twenty-five patients (48%) presented 414 events, with a final diagnosis in 230 patients (70.8% of patients with events; 33.1% of patients with follow-up). Syncope secondary to bradyarrhythmia was the most frequent diagnosis. Similar rates of final diagnoses were noted in subgroups of SHD, BBB and normal heart. Regarding the cause of implantation, higher event rates were registered among patients with recurrent syncope. CONCLUSIONS: One-third of patients obtained a final diagnosis with the ILR, independent of the baseline characteristics. Only the cause of implantation provided different rates of final diagnosis.

Embolia coronaria tras implante percutáneo de prótesis valvular aórtica / Coronary embolism after percutaneous implantation of an aortic valve prosthesis

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