open access

Vol 21, No 6 (2014)
Review paper
Published online: 2014-12-18
Get Citation

New monitoring techniques to diagnose the cause of syncope

Suneet Mittal
DOI: 10.5603/CJ.2014.0095
·
Cardiol J 2014;21(6):625-630.

open access

Vol 21, No 6 (2014)
Review articles
Published online: 2014-12-18

Abstract

Syncope is a very common clinical problem. Given the extensive differential diagnosis, we have developed a structured approach for the evaluation and management of patients with unexplained syncope. Patients with overt cardiac, neurologic, or metabolic disturbances are identified and treated accordingly. However, the remaining patients with high-risk characteristics are hospitalized for risk stratification. After excluding patients who can benefit from pacemaker or implantable cardioverter-defibrillator implantation, an implantable loop recorder (ILR) appears to be a very effective diagnostic tool. The recent availability of a small ILR that can be implanted within minutes and provides daily data wirelessly for over 3 years appears to have elevated the ILR over short-term external electrocardiography (ECG) monitoring techniques in patients with unexplained syncope. Herein, using specific case examples, we review how we use a structural pathway at our institution to guide the evaluation and management of patients presenting with unexplained syncope, identify the types of patients who benefit from long-term ECG monitoring, and show how this strategy has positively affected clinical care in these patients.

Abstract

Syncope is a very common clinical problem. Given the extensive differential diagnosis, we have developed a structured approach for the evaluation and management of patients with unexplained syncope. Patients with overt cardiac, neurologic, or metabolic disturbances are identified and treated accordingly. However, the remaining patients with high-risk characteristics are hospitalized for risk stratification. After excluding patients who can benefit from pacemaker or implantable cardioverter-defibrillator implantation, an implantable loop recorder (ILR) appears to be a very effective diagnostic tool. The recent availability of a small ILR that can be implanted within minutes and provides daily data wirelessly for over 3 years appears to have elevated the ILR over short-term external electrocardiography (ECG) monitoring techniques in patients with unexplained syncope. Herein, using specific case examples, we review how we use a structural pathway at our institution to guide the evaluation and management of patients presenting with unexplained syncope, identify the types of patients who benefit from long-term ECG monitoring, and show how this strategy has positively affected clinical care in these patients.

Get Citation

Keywords

monitoring, syncope

About this article
Title

New monitoring techniques to diagnose the cause of syncope

Journal

Cardiology Journal

Issue

Vol 21, No 6 (2014)

Article type

Review paper

Pages

625-630

Published online

2014-12-18

DOI

10.5603/CJ.2014.0095

Bibliographic record

Cardiol J 2014;21(6):625-630.

Keywords

monitoring
syncope

Authors

Suneet Mittal

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl