Role of extended external loop recorders for the diagnosis of unexplained syncope, pre-syncope, and sustained palpitations

Abstract

The diagnostic yield of ELR in patients with syncope, pre-syncope, or palpitation of unknown origin after routine workup was similar to implantable loop recorder (ILR) within the same timeframe, therefore, ELR could be considered for patients candidate for long-term ECG monitoring, stepwise before ILR.

The Evaluation of the Patient with Unexplained Palpitations: Maximizing Diagnostic Yield while Minimizing Unnecessary Frustration

“…In fact, a recent study has suggested a diagnostic yield of nearly 90% using this approach. 9 Nonetheless, the very high diagnostic yield observed with patientactivated event recorders in this study suggests that maybe the value of this technology should at least be reassessed in patients with unexplained palpitations given the inherent simplicity of this technology.…”

Diagnostic Yield of Patch Ambulatory Electrocardiogram Monitoring in Children (from a National Registry)

“…8 The diagnostic yield for the detection of an arrhythmia in our study (12.2%) was lower than in previous studies with adult subjects. In symptomatic adult patients, the diagnostic yield ranged from 15% to 86% when using a Holter monitor, 12 an event monitor, 2 an external loop recorder, 13 mobile cardiac outpatient telemetry, 10 a leadless ECG monitor, 14 a wireless patch-type external loop recorder, 15 or the Zio Patch. 8,16 The yield in adults is likely higher because of the increased prevalence of atrial fibrillation and other arrhythmias with age.…”

Use of a Patient-Activated Event Recording System in Patients with Tachycardic Palpitations: How Long to Follow Up?

“…Another recently performed analysis even found a 86% diagnostic yield for palpitations when an external loop recorder was used. 8 All these studies were performed using a "standard" loop recorder with electrode patches. The "leadless" event recorder used in our study was previously compared by Scherr et al to the standard event recorder in the diagnosis of patients with palpitations.…”