Discrepancy between clinical practice and standardized indications for an implantable loop recorder in patients with unexplained syncope

Europace

Volumn 12, Issue 10, 2010, Pages 1475-1479

  Vitale, Elena ^a   Ungar, Andrea ^b   Maggi, Roberto ^c   Francese, Maura ^d   Lunati, Maurizio ^e   Colaceci, Roberto ^f   Del Rosso, Attilio ^g   Castro, Antonio ^h   Santini, Massimo ⁱ   Giuli, Silvia ^j   Belgini, Lara ^j   Casagranda, Ivo ^a   Brignole, Michele ^c  

^a Biagio e Cesare Arrigo   (Italy)

^b UNIVERSITY OF FLORENCE   (Italy)

^c DEPARTMENT OF CARDIOLOGY   (Italy)

^d GARIBALDI HOSPITAL   (Italy)

^e OSPEDALE NIGUARDA CA GRANDA   (Italy)

^f Ospedale Grassi   (Italy)

^g SAN GIUSEPPE HOSPITAL   (Italy)

^h SANDRO PERTINI HOSPITAL   (Italy)

ⁱ SAN FILIPPO NERI HOSPITAL   (Italy)

^j Medtronic Italia   (Italy)

more..

Author keywords

Electrocardiographic monitoring; Implantable loop recorders guidelines; Syncope

Indexed keywords

ADULT; AGED; ARTICLE; CLINICAL EVALUATION; CLINICAL PRACTICE; ELECTROCARDIOGRAPHY MONITORING; FEMALE; HEART BUNDLE BRANCH BLOCK; HUMAN; IMPLANTABLE LOOP RECORDER; ISCHEMIC HEART DISEASE; MAJOR CLINICAL STUDY; MALE; PATIENT SELECTION; PRACTICE GUIDELINE; PRIORITY JOURNAL; SYNCOPE; TREATMENT INDICATION;

AGED; AGED, 80 AND OVER; ELECTROCARDIOGRAPHY, AMBULATORY; ELECTRODES, IMPLANTED; FEMALE; HUMANS; MALE; MIDDLE AGED; MULTICENTER STUDIES AS TOPIC; PRACTICE GUIDELINES AS TOPIC; SYNCOPE;

EID: 77957733587     PISSN: 10995129     EISSN: 15322092     Source Type: Journal    
DOI: 10.1093/europace/euq302     Document Type: Article

References (22)

1. Moya A, Sutton R, Ammirati F, Blanc JJ, Brignole M, Dahm JB et al. Guidelines for the Diagnosis and Management of Syncope (Version 2009). Eur Heart J 2009;30:2631-71.
2. Solano A, Menozzi C, Maggi R, Donateo P, Bottoni N, Lolli G et al. Incidence, diagnostic yield and safety of the implantable loop-recorder to detect the mechanism of syncope in patients with and without structural heart disease. Eur Heart J 2004;25:1116-9.
3. Brignole M, Menozzi C, Bartoletti A, Giada F, Lagi A, Ungar A et al. A new management of syncope: prospective systematic guideline-based evaluation of patients referred urgently to general hospital. Eur Heart J 2006;27:76-82.
4. Brignole M, Ungar A, Casagranda I, Gulizia M, Lunati M, Ammirati F et al. Prospective multicentre systematic guideline-based management of patients referred to the Syncope Units of general hospital. Europace 2010;12:109-18.
5. Brignole M, Vardas P, Hoffman E, Huikuri H, Moya A, Ricci R et al. Indications for the use of diagnostic implantable and external ECG loop recorders. Europace 2009;11:671-87.
6. Colivicchi F, Ammirati F, Melinab D, Guido V, Imperoli G, Santini M for the OESIL (Osservatorio Epidemiologico sulla Sincope nel Lazio) study investigators. Development and prospective validation of a risk stratification system for patients with syncope in the emergency department: the OESIL risk score. Eur Heart J 2003;24:811-9.
7. Del Rosso A, Ungar A, Maggi R, Giada F, Petix NR, De Santo T et al. Clinical predictors of cardiac syncope at initial evaluation in patients referred urgently to a general hospital: the EGSYS score. Heart 2008;94:1620-6.
8. Kapoor WH, Hanusa B. Is syncope a risk factor for poor outcomes? Comparison of patients with or without syncope. Am J Med 1996;100:646-55.
9. Moya A, Brignole M, Garcia-Civera R, Tognarini S, Mont L, Botto G et al. Mechanism of syncope in patients with isolated syncope and in patients with tiltpositive syncope. Circulation 2001;104:1261-7. (Pubitemid 32848115)
10. Menozzi C, Brignole M, Garcia-Civera R, Moya A, Botto G, Tercedor L et al. Mechanism of syncope in patients with heart disease and negative electrophysiologic test. Circulation 2002;105:2741-5.
11. Brignole M, Menozzi C, Moya A, Garcia-Civera R, Mont L, Alvarez M et al. Mechanism of syncope in patients with bundle branch block and negative electrophysiologic test. Circulation 2001;104:2045-50.
12. Brignole M, Sutton R, Menozzi C, Garcia-Civera R, Moya A, Wielling W et al. for the International Study on Syncope of Uncertain Etiology 2 (ISSUE 2) Group. Early application of an implantable loop recorder allows effective specific therapy in patients with recurrent suspected neurally mediated syncope. Eur Heart J 2006;27:1085-92.
13. Krahn A, Klein G, Norris C, Yee R, Takle-Newhouse T, Norris C. Use of an extended monitoring strategy in patients with problematic syncope. Reveal Investigators. Circulation 1999;99:406-10.
14. Niepor P, Van Mechelen R, Van Elsacker A, Luijten R, Elhendy A. Heart rhythm during syncope and pre-syncope. Pacing Clin Electrophysiol 2000;23:1532-8.
15. Boersma L, Mont L, Sionis A, Garcia E, Brugada J. Value of implantable loop recorder for the management of patients with unexplained syncope. Europace 2004;6:70-6.
16. Lombardi F, Calosso E, Mascioli G, Marangoni E, Donato A, Rossi S et al. Utility of implantable loop recorder (Reveal Plus) in the diagnosis of unexplained syncope. Europace 2005;7:19-24.
17. Krahn A, Klein G, Yee R, Skanes A. Randomized Assessment of Syncope Trial: conventional diagnostic testing versus a prolonged monitoring strategy. Circulation 2001;104:646-51.
18. Maggi R, Menozzi C, Brignole M, Podoleanu C, Iori M, Sutton R et al. Cardioinhibitory carotid sinus hypersensitivity predicts an asystolic mechanism of spontaneous neurally mediated syncope. Europace 2007;9:563-7.
19. Farwell D, Freemantle N, Sulke N. The clinical impact of implantable loop recorders in patients with syncope. Eur Heart J 2006;27:351-6.
20. Zaidi A, Clough P, Cooper P, Scheepers B, Fitzpatrick A. Misdiagnosis of epilepsy: many seizure-like attacks have a cardiovascular cause. J Am Coll Cardiol 2000;36:181-4.
21. Rugg-Gunn F, Simister R, Squirrel M, Holdright D, Ducan J. Cardiac arrhythimias in focal epilepsy: a prospective long term study. Lancet 2004;363:2212-9.
22. Armstrong L, Lawson J, Kamper A, Newton J, Kenny RA. The use of implantable loop recorder in the investigation of unexplained syncope in older people. Age Ageing 2003;32:185-8.