Arcinas Liane A, McIntyre William F, Hayes Christopher J, Ibrahim Omar A, Baranchuk Adrian M, Seifer Colette M
Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
Ann Noninvasive Electrocardiol. 2019 May;24(3):e12630. doi: 10.1111/anec.12630. Epub 2019 Jan 7.
An implantable loop recorder (ILR) assists in the diagnosis of unexplained syncope and atrial fibrillation (AF). Both become prevalent with age. Limited data exist describing the incidence of AF as the diagnostic rhythm underlying syncope in the elderly. This study aims to report the incidence of AF in older adults with ILRs for unexplained syncope and identify clinical characteristics associated with AF in this population.
Retrospective observational study on patients with unexplained syncope seen in syncope clinics from two Canadian centers. Participants were ≥65 years old, without a history of AF, and received an ILR for unexplained syncope. Data were collected from patient's clinic charts. Arrhythmia diagnosis was based on ILR electrocardiogram reading during syncope (symptom-rhythm correlation). Fisher's exact test and the Student's t test were used to compare participants with and without AF.
In our cohort of 222 patients, 124 were females and 98 were males. Mean age at implant was 80 ± 8 years. Arrhythmia was diagnosed in 98 patients (44.1%). Median time to diagnosis was 18 months. AF was diagnosed in 17 (7.7%) participants. There were fewer males in the AF group than the no AF group (11.8%, 46.8%, p = 0.01). Age, baseline EKG, and prevalence of hypertension, diabetes, stroke, or ischemic heart disease were not statistically different between patients with AF and without AF.
Atrial fibrillation was a common diagnostic rhythm in this cohort of adults, aged 65 and older, with ILRs for unexplained syncope. It was observed more frequently in females.
植入式循环记录仪（ILR）有助于不明原因晕厥和心房颤动（AF）的诊断。这两种情况都随着年龄增长而变得普遍。关于AF作为老年人晕厥潜在诊断节律的发生率的数据有限。本研究旨在报告使用ILR诊断不明原因晕厥的老年人中AF的发生率，并确定该人群中与AF相关的临床特征。
对来自加拿大两个中心晕厥诊所中不明原因晕厥患者进行回顾性观察研究。参与者年龄≥65岁，无AF病史，因不明原因晕厥接受了ILR。数据从患者的临床病历中收集。心律失常诊断基于晕厥期间ILR心电图读数（症状-节律相关性）。采用Fisher精确检验和Student t检验比较有AF和无AF的参与者。
在我们的222例患者队列中，女性124例，男性98例。植入时的平均年龄为80±8岁。98例患者（44.1%）诊断出心律失常。诊断的中位时间为18个月。17例（7.7%）参与者诊断出AF。AF组男性少于无AF组（11.8%对46.8%，p = 0.01）。AF患者和无AF患者之间的年龄、基线心电图以及高血压、糖尿病、中风或缺血性心脏病的患病率无统计学差异。
在这个65岁及以上因不明原因晕厥使用ILR的成年人队列中，心房颤动是一种常见的诊断节律。在女性中观察到的频率更高。
