Objective Patients with heart disease are at increased risk for sudden cardiac death. Guidelines recommend an implantable loop recorder (ILR) for symptomatic patients when symptoms are sporadic and possibly arrhythmia-related. In clinical practice, an ILR is mainly used in patients with unexplained syncope. We aimed to compare the clinical value of an ILR in patients with heart disease and a history of syncope versus those with non-syncopal symptoms. Methods In this observational single-centre study, we included symptomatic patients with heart disease who received an ILR. The primary endpoint was an actionable event which was defined as an arrhythmic event leading to a change in clinical management. The secondary endpoint was an event leading to device implantation. Results One hundred and twenty patients (mean age 47±17 years, 49% men) were included. The underlying disease substrate was inherited cardiomyopathy (31%), congenital heart disease (28%), channelopathy (23%) and other (18%). Group A consisted of 43 patients with prior syncope and group B consisted of 77 patients with palpitations and/or near-syncope. The median follow-up duration was 19 months (IQR 8–36). The 3-year cumulative event rate was similar between groups with regard to the primary endpoint (38% vs 39% for group A and B, respectively, logrank p=0.54). There was also no difference in the 3-year cumulative rate of device implantation (21% vs 13% for group A and B, respectively, logrank p=0.65). Conclusion In symptomatic patients with heart disease, there is no difference in the yield of an ILR in patients presenting with or without syncope. Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.

中文翻译：

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心脏病患者植入式循环记录仪：有晕厥和无晕厥的患者之间的比较


目的 心脏病患者发生心源性猝死的风险增加。当症状是零星的并且可能与心律失常相关时，指南建议为有症状的患者使用植入式循环记录仪（ILR）。在临床实践中，ILR主要用于不明原因晕厥的患者。我们的目的是比较 ILR 对于心脏病和有晕厥病史的患者与无晕厥症状的患者的临床价值。方法 在这项观察性单中心研究中，我们纳入了接受 ILR 治疗的有症状的心脏病患者。主要终点是可采取行动的事件，其定义为导致临床管理改变的心律失常事件。次要终点是导致装置植入的事件。结果 纳入 120 名患者（平均年龄 47±17 岁，49% 为男性）。潜在的疾病基础是遗传性心肌病（31%）、先天性心脏病（28%）、通道病（23%）和其他（18%）。 A 组由 43 名既往晕厥的患者组成，B 组由 77 名有心悸和/或接近晕厥的患者组成。中位随访时间为 19 个月（IQR 8-36）。就主要终点而言，各组之间的 3 年累积事件发生率相似（A 组和 B 组分别为 38% 和 39%，对数秩 p=0.54）。装置植入的 3 年累积率也没有差异（A 组和 B 组分别为 21% 和 13%，对数秩 p=0.65）。结论 在有症状的心脏病患者中，伴有或不伴有晕厥的患者的 ILR 产量没有差异。数据可根据合理要求提供。与研究相关的所有数据都包含在文章中或作为补充信息上传。