Use of implantable loop recorders in the diagnosis and management of syncope.
Eur Heart J
; 25(14): 1257-63, 2004 Jul.
Article
em En
| MEDLINE
| ID: mdl-15246645
ABSTRACT
BACKGROUND:
Syncope is a common, disabling symptom. The most useful data for diagnosing and managing syncope is the recording of physical parameters such as the ECG and blood pressure during a spontaneous event. Implantable loop recorders (ILR) provide an opportunity to record ECG data from a spontaneous event. The purpose of the Eastbourne Syncope Assessment Study (EaSyAS) was to investigate the impact of ILRs on an unselected population of syncopal patients presenting acutely to our institution.METHODS:
All patients presenting acutely with recurrent, unexplained syncope over a 16-month period, were randomised after a basic clinical workup to receive the Reveal Plus ILR or conventional investigation. All patients were followed up for at least 6 months (mean 276+/-134 days) following randomisation. The primary outcome measure was time to ECG diagnosis.RESULTS:
Four hundred twenty-one patients presented, 201 were eligible, median age 74 years (interquartile range 61-81 years), 54% female, with a median of three previous syncopes (IQ range 2-6). Thirty-three percent of ILR patients and 4% of conventional patients had an ECG diagnosis (hazard ratio 8.93, 95% CI 3.17-25.2, p < or = 0.0001). Introduction of ECG-directed therapy was quicker for ILR patients (hazard ratio 7.9, 95% CI 2.8-22.3, p < 0.0001). ILR patients had fewer post-randomisation investigations and fewer hospital days, resulting in a saving of costs, 406 UK pounds versus 1210 UK pounds (mean difference 809 UK pounds, 95% CI 123-2730 UK pounds). There was no difference in the number of subsequent syncopal episodes, mortality, or quality of life.CONCLUSIONS:
LR significantly increased the rate of diagnosis in an unselected Western population with recurrent syncope. There was a significant decrease in the rates of hospitalisation and investigation in patients receiving an ILR.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Síncope
/
Eletrocardiografia
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
Aspecto:
Patient_preference
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Eur Heart J
Ano de publicação:
2004
Tipo de documento:
Article
País de afiliação:
Reino Unido
País de publicação:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
/
UK
/
UNITED KINGDOM