open access
New monitoring techniques to diagnose the cause of syncope
open access
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.
Keywords
monitoring, syncope
About this articleTitle
New monitoring techniques to diagnose the cause of syncope
Journal
Issue
Article type
Review Article
Pages
625-630
Published online
2014-12-18
Page views
1694
Article views/downloads
2136
DOI
10.5603/CJ.2014.0095
Bibliographic record
Cardiol J 2014;21(6):625-630.
Keywords
monitoring
syncope
Authors
Suneet Mittal
