Archontakis Stefanos, Oikonomou Evangelos, Sideris Konstantinos, Dourvas Panagiotis, Milaras Nikias, Kostakis Panagiotis, Klogkeri Tzonatan, Triantafyllou Epameinondas, Theofilis Panagiotis, Ntalakouras Ioannis, Arsenos Petros, Gkika Athanasia, Gatzoulis Konstantinos, Sideris Skevos, Tousoulis Dimitris
Department of Cardiology, Hippokration General Hospital, 114 Vasilisis Sofias Str., 11527 Athens, Greece.
Third Cardiology Division, Medical School, University of Athens, Sotiria Thoracic Diseases Hospital, 152 Mesogeion Ave., 11527 Athens, Greece.
Life (Basel). 2024 Jul 12;14(7):871. doi: 10.3390/life14070871.
Syncope remains a common medical problem. Recently, the role of dedicated syncope units and implantable loop recorders has emerged in the investigation of unexplained syncope. This study aims to investigate the possibilities for a more rational and targeted use of various diagnostic tools.
In this retrospective single-center study, 196 patients with unexplained syncope were included between March 2019 and February 2023. Various diagnostic tools were utilized during the investigation, according to clinical judgement. Patients were retrospectively allocated into Group A (including those who, among other tests, underwent loop recorder insertion) and Group B (including patients investigated without loop recorder implantation). Data were compared with Group C, including patients assessed prior to syncope unit establishment.
There was no difference between Group A ( = 133) and Group B ( = 63) in the diagnostic yield (74% vs. 76%, = 0.22). There were significant differences between Groups A and B regarding age (67.3 ± 16.9 years vs. 48.3 ± 19.1 years, < 0.001) and cause of syncope (cardiogenic in 69% of Group A, reflex syncope in 77% of Group B, < 0.001). Electrocardiography-based diagnosis occurred in 55% and 19% of Groups A and B, respectively ( < 0.001). The time to diagnosis was 4.2 ± 2.7 months in Group A and 7.5 ± 5.6 months in Group B ( < 0.001). In Group C, the diagnostic yield was 57.9% and the electrocardiography-based diagnostic yield was 18.3%.
A selective use of loop recorders according to clinical and electrocardiographic characteristics increases the effectiveness of the structured syncope unit approach and further preserves financial resources.
晕厥仍是一个常见的医学问题。最近，专门的晕厥单元和植入式环路记录器在不明原因晕厥的调查中发挥了作用。本研究旨在探讨更合理、有针对性地使用各种诊断工具的可能性。
在这项回顾性单中心研究中，纳入了2019年3月至2023年2月期间196例不明原因晕厥患者。根据临床判断，在调查过程中使用了各种诊断工具。患者被回顾性分为A组（包括那些除其他检查外还进行了环路记录器植入的患者）和B组（包括未植入环路记录器进行检查的患者）。数据与C组进行比较，C组包括在晕厥单元建立之前评估的患者。
A组（n = 133）和B组（n = 63）的诊断率无差异（74%对76%，P = 0.22）。A组和B组在年龄（67.3±16.9岁对48.3±19.1岁，P < 0.001）和晕厥原因（A组69%为心源性，B组77%为反射性晕厥，P < 0.001）方面存在显著差异。基于心电图的诊断在A组和B组中分别为55%和19%（P < 0.001）。A组的诊断时间为4.2±2.7个月，B组为7.5±5.6个月（P < 0.001）。在C组中，诊断率为57.9%，基于心电图的诊断率为18.3%。
根据临床和心电图特征选择性使用环路记录器可提高结构化晕厥单元方法的有效性，并进一步节省资金。
