Cardiology Division S. Giovanni di Dio Hospital, Florence, Italy -
Minerva Med. 2013 Aug;104(4):421-9.
Aim of the study was to compare the diagnostic yield of implantable loop recorders (ILR) of two successive generations for the assessment of syncope.
Data on patients who had undergone ILR implantation for unexplained syncope in four Italian public hospitals were retrospectively acquired from the Medtronic Clinical Service database. After implantation, routine follow-up examinations were performed every 90 days, while urgent examinations were carried out in the event of syncope recurrence.
The following findings were regarded as diagnostic: ECG documentation of a syncope recurrence; documentation of any of the arrhythmias listed by the current guidelines as diagnostic findings even if asymptomatic. Between November 2002 and March 2010, 107 patients received an ILR (40 Medtronic Reveal® Plus; 67 Medtronic Reveal® DX/XT) and underwent at least one follow-up examination. Diagnoses were made in 7 (17.5%) and 24 (35.8%) (P=0.043) patients, with a median time of 228 and 65 days, respectively. Three (42.9%) and 21 (87.5%) (P=0.029) diagnoses were based on automatically detected events, while adverse outcomes occurred in 6 and in 1 (P=0.01) patients, respectively.
Our results show that the new-generation device offer a higher diagnostic yield, mainly as a result of its improved automatic detection function, and is associated with fewer adverse outcomes.
本研究旨在比较两代植入式循环记录器（ILR）在评估晕厥中的诊断效果。
从美敦力临床服务数据库中回顾性获取意大利四家公立医院因不明原因晕厥而植入 ILR 的患者数据。植入后，每 90 天进行常规随访检查，在晕厥复发时进行紧急检查。
以下发现被视为诊断结果：ECG 记录到晕厥复发；记录到现行指南中列出的任何心律失常，即使无症状。2002 年 11 月至 2010 年 3 月，107 例患者接受了 ILR（40 例美敦力 Reveal® Plus；67 例美敦力 Reveal® DX/XT）植入，并进行了至少一次随访检查。分别有 7（17.5%）和 24（35.8%）（P=0.043）例患者做出了诊断，中位时间分别为 228 天和 65 天。分别有 3（42.9%）和 21（87.5%）（P=0.029）例诊断基于自动检测到的事件，而分别有 6 例和 1 例（P=0.01）患者出现不良结局。
我们的结果表明，新一代设备的诊断效果更高，主要是由于其自动检测功能的改进，且与较少的不良结局相关。
