Description:
<jats:title>Abstract</jats:title>
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<jats:title>Funding Acknowledgements</jats:title>
<jats:p>Type of funding sources: None.</jats:p>
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<jats:title>INTRODUCTION</jats:title>
<jats:p>Symptoms like syncope and palpitations are frequent and represent a diagnostic challenge. The implantable loop recorder (LR) is an important diagnostic tool, in selected cases.</jats:p>
<jats:p>AIM</jats:p>
<jats:p>To describe the main implantation indications of LR and to evaluate the diagnostic findings and therapeutic interventions.</jats:p>
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<jats:title>METHODS</jats:title>
<jats:p>A retrospective study of patients (pts) that underwent LR implantation in our hospital from 2014 to 2019.</jats:p>
<jats:p>For each pt the indication for implantation, baseline characteristics, previous study, recorded tracing and interventions were evaluated.</jats:p>
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<jats:title>RESULTS</jats:title>
<jats:p>A total of 52 pts were included, 56% women, with a mean age of 60 years old.</jats:p>
<jats:p>The implantation indications were recurrent syncope/ presyncope in 47 pts (90%) and palpitations in 5 pts (10%).</jats:p>
<jats:p>All pts had a baseline echocardiogram and electrocardiogram, with 90% in sinus rhythm. QRS complex and atrial-ventricular conduction was normal in 50% of the pts.</jats:p>
<jats:p>Previous to LR implantation, 46 pts (89%) had performed Holter, 19 (37%) carotid sinus massage, 14 (27%) Tilt table test, 29 (56%) stress test, 11(21%) ambulatory blood pressure monitoring and 9 (17%) electrophysiological study.</jats:p>
<jats:p>During the monitoring period, 27 pts (52%) had recurrence of the symptoms.</jats:p>
<jats:p>In this subgroup, we observed that 67% had a rhythmic cause capable of justified the symptoms, with a median of 5 months since implantation until diagnosis. In addition, the LR was useful in ruling out a rhythmic cause for symptoms in 33% of the cases.</jats:p>
<jats:p>In the 47 pts with syncope/presyncope: 6(13%) had sinus node dysfunction, 4 (9%) had atrioventricular conduction disturbance, 1(2%) had atrial fibrillation (AF) and 3 (6%) had ventricular dysrhythmias.</jats:p>
<jats:p>In the 5 pts with palpitations: 1(20%) had AF ad 3 (60%) had paroxysmal supraventricular tachycardia.</jats:p>
<jats:p>LR results led to cardiac device implantation in 13 pts (pacemaker-9, implantable cardioverter desfibrillator-4). In addition, 2 pts are waiting for electrophysiological study and eventual ablation and 3 pts initiated antiarrhythmic therapy, and those with new diagnosis of AF also initiated oral anticoagulants.</jats:p>
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<jats:title>CONCLUSION</jats:title>
<jats:p>In this study, the implantation of LR was useful to clarify the cause of the symptomology in 52% of the pts.</jats:p>
<jats:p>In 35% of pts with symptom-rhythm correlation it ensured timely introduction of therapeutic approach with a positive impact on life quality.</jats:p>
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