SPC365

Caught in a loop: one center's experience with ILR

Session: Posters (Sessão 4 - Écran 1) - Dispositivos em Arritmologia
Speaker: Inês Macedo Conde

Congress: CPC 2023
Topic: C. Arrhythmias and Device Therapy
Theme: 09. Device Therapy
Subtheme: 09.6 Device Therapy - Other
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Inês Macedo Conde; Carla Marques-Pires; Paulo Medeiros; Rui Flores; Fernando Mané; Rodrigo Silva; Mónica Dias; Ana Sofia Fernandes; Carina Arantes; Sónia Magalhães; Sérgia Rocha; Adília Rebelo; Nuno Antunes; Catarina Quina-Rodrigues
<p style="text-align:justify"><span style="font-size:11px"><span style="font-family:Verdana,Geneva,sans-serif"><span style="color:#000000">INTRODUCTION</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11px"><span style="font-family:Verdana,Geneva,sans-serif"><span style="color:#000000">Syncope/pre-syncope and palpitations are two of the most frequent causes for referral to Cardiology. Due to their unpredictable nature, with variable rate of recurrence, they present a diagnostic challenge. In this setting, implantable loop recorder (ILR) have emerged as an important diagnostic tool.</span></span></span></p>

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<p style="text-align:justify"><span style="font-size:11px"><span style="font-family:Verdana,Geneva,sans-serif"><span style="color:#000000">GOALS</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11px"><span style="font-family:Verdana,Geneva,sans-serif"><span style="color:#000000">Characterize the main indications for the implantation of an ILR and evaluate the diagnostic findings and subsequent therapeutic interventions.</span></span></span></p>

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<p style="text-align:justify"><span style="font-size:11px"><span style="font-family:Verdana,Geneva,sans-serif"><span style="color:#000000">METHODS</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11px"><span style="font-family:Verdana,Geneva,sans-serif"><span style="color:#000000">Single-centre analytical, observational, retrospective study, including all the patients who underwent ILR implantation between January 2014 and December 2021. Data regarding patients characteristics, reason for implantation, previous complementary exams, information provided by the ILR and subsequently instituted therapies.</span></span></span></p>

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<p style="text-align:justify"><span style="font-size:11px"><span style="font-family:Verdana,Geneva,sans-serif"><span style="color:#000000">RESULTS</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11px"><span style="font-family:Verdana,Geneva,sans-serif"><span style="color:#000000">A total of 135 patients were included, 51,1% females, mean age of 60,7 &plusmn; 16,5 years. All patients were previously studied with electrocardiogram and transthoracic echocardiogram. The implant indications were: syncope/presyncope (85.9%), palpitations (8.1%) and other reasons (6.7%). The majority of patients had been referred from the outpatient consultation (81,6%) and the median time from the beginning of the investigation to the implantation of the ILR was 6,4 months (IQR 1-7).&nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11px"><span style="font-family:Verdana,Geneva,sans-serif"><span style="color:#000000">Of the 116 patients submitted to ILR implantation due to syncope/pre-syncope, 56 (48,2%) reported symptoms, of which 28 (24,1%) had diagnostic rhythmic findings, and 10 (8,6%) had diagnostic findings without symptoms. The most frequent dysrhythmic disorder&nbsp; was sinus node dysfunction (16,4%), followed by advanced atrioventricular block (6,9%).</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11px"><span style="font-family:Verdana,Geneva,sans-serif"><span style="color:#000000">Of the 10 patients submitted to ILR implantation due to palpitations, 4 reported symptoms, 2 of which had diagnostic findings, and 2 had had diagnostic findings without symptoms. Definitive diagnosis was possible in 4 patients: 3 with PSVT and 1 with AF.&nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11px"><span style="font-family:Verdana,Geneva,sans-serif"><span style="color:#000000">Overall, a rhythmic diagnosis was reached in 42 patients (30,9%), with a median time from device implantation to diagnosis of 6 months (IQR 2-12). Symptoms without diagnostic findings were reported in 30 patients (22,1%), suggesting a non-rhythmic cause for their complaints.&nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11px"><span style="font-family:Verdana,Geneva,sans-serif"><span style="color:#000000">The following interventions were made: 31 devices were implanted, 4 patients were submitted to ablation therapy. Additionally, 2 patients were treated medically with rhythm control strategy, 4 patients with rate control strategy and 7 started oral anticoagulation.&nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11px"><span style="font-family:Verdana,Geneva,sans-serif"><span style="color:#000000">The median follow up time was 14 months (IQR 9-22). No complications were reported and the mortality rate was 2,2%, resulting from non-cardiac causes.&nbsp;</span></span></span></p>

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<p style="text-align:justify"><span style="font-size:11px"><span style="font-family:Verdana,Geneva,sans-serif"><span style="color:#000000">CONCLUSION</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11px"><span style="font-family:Verdana,Geneva,sans-serif"><span style="color:#000000">In this sample, the use of an ILR allowed the diagnosis in 30,9% of patients and culminated in an intervention in 30,1% of cases. In our experience, it constitutes a useful and safe complementary diagnostic method, with additional value to other diagnostic tools.&nbsp;</span></span></span></p>