ECG de abril de 2018 / ECG, April 2018

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Experiencia con el uso del registrador implantable de eventos en una serie depersonas mayores con caídas y sospecha de síncopes de origen arrítmico / Experience with the use of an implantable loop recorder in a series of older people with falls and suspected arrhythmic syncopes

Objetivo: Describir nuestra experiencia con la utilización del registrador implantable de eventos (REI) en un grupo de pacientes mayores con caídas frecuentes, y factores predictores de síncope de causa arrítmica. Material y métodos: Estudio retrospectivo de pacientes mayores con caídas, sospecha de síncope y/o alteraciones en el ECG, a quienes tras una evaluación cardiológica se les implantó un REI, para esclarecer si las caídas estaban provocadas por una arritmia. Resultados: Se han analizado 13 pacientes (7 varones con una edad media de 78 a˜ nos), con una media de 3,3 caídas, a los que se implantó un REI como parte del estudio de las mismas. Han sido seguidos durante un periodo mínimo de 24 meses. Seis pacientes han mostrado una arritmia como causa de las caídas, registrada en el REI. En 5 casos se trataba de una bradiarritmia. El otro era una taquiarritmia. Cuatro pacientes no han presentado alteraciones del ritmo cardíaco durante las caídas. Los restantes 3 pacientes no han sufrido nuevas caídas durante el seguimiento. Conclusión: En este grupo seleccionado de pacientes con caídas, el REI ha detectado una causa arrítmica en un apreciable porcentaje de casos (AU)

Objective: To review our experience on using an implantable loop recorder (ILR) in patients with recurrent falls, when an arrhythmogenic cause is suspected. Material and methods: This is a retrospective, observational study of patients with repetitive unexplained falls, suspected syncope, or electrocardiographic abnormalities. All of them had been evaluated by a cardiologist, who decided to implant a loop recorder (ILR) for an accurate diagnosis. Results: A total of 13 patients received an ILR. The average falls rate for the sample was 3.3. The mean age was 78 years, and 46% were female, with a mean follow-up period of 24 months. During this time, three patients did not suffer from a new fall. An arrhythmogenic diagnosis was obtained in 5 patients: bradycardia was identified in 4 cases, and tachycardia in one of them. The symptoms did not coincide with a documented arrhythmia in the rest of the patients. Conclusion: ILR is a helpful tool to establish an arrhythmogenic cause of unexplained and recurrent falls, in this selected sample of older adults (AU)

[Experience with the use of an implantable loop recorder in a series of older people with falls and suspected arrhythmic syncopes]. / Experiencia con el uso del registrador implantable de eventos en una serie de personas mayores con caídas y sospecha de síncopes de origen arrítmico.

OBJECTIVE: To review our experience on using an implantable loop recorder (ILR) in patients with recurrent falls, when an arrhythmogenic cause is suspected. MATERIAL AND METHODS: This is a retrospective, observational study of patients with repetitive unexplained falls, suspected syncope, or electrocardiographic abnormalities. All of them had been evaluated by a cardiologist, who decided to implant a loop recorder (ILR) for an accurate diagnosis. RESULTS: A total of 13 patients received an ILR. The average falls rate for the sample was 3.3. The mean age was 78 years, and 46% were female, with a mean follow-up period of 24 months. During this time, three patients did not suffer from a new fall. An arrhythmogenic diagnosis was obtained in 5 patients: bradycardia was identified in 4 cases, and tachycardia in one of them. The symptoms did not coincide with a documented arrhythmia in the rest of the patients. CONCLUSION: ILR is a helpful tool to establish an arrhythmogenic cause of unexplained and recurrent falls, in this selected sample of older adults.

Congenital complete atrioventricular block and preexcitation syndrome: a well-matched partner.

A patient who had been previously diagnosed with congenital complete atrioventricular block (CCAVB) twenty years ago developed atrioventricular (AV) conduction through an accessory pathway (AP). With enhanced sympathetic tone (exercise, isoproterenol), 1:1 conduction down the AP occurred. An electrophysiologic study confirmed a suprahissian AV block and the presence of an AP. The AP was located on the left side and posterior. The absence of retrograde conduction through the AP and also a long conduction time were demonstrated.