부산대학교 도서관

Aim: To compare the diagnostic yield of implantable loop recorders (ILR) of two successive generations for the assessment of syncope.Methods: Data on patients who had undergone ILR implantation for unexplained syncope in four Italian public hospitals were 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.Results: 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 events occurred in 6 and in 1 (p=0.01) patients, respectively.Conclusion: Our results show that the new-generation device offers a higher diagnostic yield, mainly as a result of its improved automatic detection function, and is associated with fewer adverse events.