Login
Search
Search
0 Dates
2025
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
CPC 2025
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Predictors of Pacemaker Implantation in Patients Undergoing Implantable Loop Recorder Monitoring for Suspected Bradycardic Syncope
Session:
SESSÃO DE POSTERS 55 - ARRITMOLOGIA: NOVOS DESAFIOS
Speaker:
João Gouveia Fiuza
Congress:
CPC 2025
Topic:
C. Arrhythmias and Device Therapy
Theme:
07. Syncope and Bradycardia
Subtheme:
07.3 Syncope and Bradycardia - Diagnostic Methods
Session Type:
Cartazes
FP Number:
---
Authors:
João Gouveia Fiuza; Gonçalo RM Ferreira; Mariana Duarte Almeida; Oliver Kungel; Francisco Rodrigues Santos; Vanda Devesa Neto; João Miguel Santos; Júlio Gil Pereira; António Costa
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Introduction: </strong>Implantable loop recorders (ILR) are widely used to investigate unexplained syncope, palpitations and cryptogenic stroke. However, the diagnostic yield of ILRs in bradycardic syncope and their influence on subsequent clinical decisions, such as permanent pacemaker (PPM) implantation, remain areas of investigation. </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Purpose: </strong>To identify clinical and electrocardiographic predictors of PPM implantation in patients with suspected arrhythmic syncope in patients with ILR.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Methods: </strong>Retrospective study of 119 patients that underwent ILR implantation for unexplained suspected bradycardic syncope. Baseline characteristics, symptoms and electrocardiographic parameters were analyzed prior to ILR implantation. Chi-square and Mann-Whitney U were used for comparison between groups. A multivariate logistic regression analysis was performed to identify independent predictors of PPM implantation.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Results:</strong> Mean age was 62±17 years; 60.5% were women. After ILR placement, 17.6% of patients underwent PPM placement. We found that patients with second degree Mobitz I conduction abnormality (80% vs 16.8%, χ2=11.966, p<0.001), first-degree AV block (45.5% vs 14.8%, χ2=6.449, p=0.024), sinus pauses (100% vs 16.1%, χ2=13.788, p<0.005), abnormal baseline electrocardiogram (sinus bradycardia, repolarization, AV or intraventricular conduction abnormalities) (27.6 % vs 8.2%, χ2=6.593, p=0.01), abnormal 24-hour Holter monitoring (non-significant pauses or significant burden of premature contractions) (29.3% vs 6.5%, χ2=7.861, p<0.005), typical symptoms (48.3 % vs 7.8%, χ2=24.752, p<0.001) and fall with associated trauma (37.2 % vs 6.8%, χ2= 16.823, p<0.001) had more PPM implants. We did not find statistically significant differences in advanced age (p=0.184), sex (p=0.52), past medical history or drugs, right bundle branch block (BBB) (p=0.383), left BBB (p=0.426) or prolonged QT interval (p= 0.746). We conducted logistic regression to determine independent predictors. Fall with associated trauma (OR: 4.89, 95% CI: 1.47–16.30, p = 0.010) and the presence of typical symptoms (OR: 7.45, 95% CI: 2.33–23.81, p < 0.001) emerged as strong independent predictors of PPM implantation following ILR monitoring. First-degree AV block exhibited a trend towards significance (OR: 4.59, 95% CI: 0.94–22.58, p = 0.060) although not reaching significance. The model demonstrated good calibration (Hosmer-Lemeshow p = 0.819) and an overall accuracy of 85.3%. </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Conclusion:</strong> This study highlights that the presence of typical symptoms and fall with associated trauma are key independent predictors of PPM implantation following ILR monitoring. These findings underscore the importance of careful clinical evaluation, as these predictors can help refine patient selection, optimize resource utilization and potentially improve outcomes.</span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site