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Miniaturized Implantable Loop Recorder in Small Patients: An Effective Approach to the Evaluation of Subjects at Risk of Sudden Death
Author(s) -
PLACIDI SILVIA,
DRAGO FABRIZIO,
MILIONI MADDALENA,
VERTICELLI LETIZIA,
TAMBURRI ILARIA,
SILVETTI MASSIMO STEFANO,
DI MAMBRO CORRADO,
RIGHI DANIELA,
GIMIGLIANO FABRIZIO,
RUSSO MARIO SALVATORE,
PALMIERI ROSALINDA,
REMOLI ROMOLO,
SANTUCCI LORENZO MARIA,
TOZZI ALBERTO EUGENIO
Publication year - 2016
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12866
Subject(s) - medicine , implantable loop recorder , palpitations , sudden cardiac death , etiology , cardiology , sudden death , atrial fibrillation
Background The etiological diagnosis of syncope and/or palpitations in children is often challenging. However, when noninvasive conventional examinations are inconclusive, the subcutaneous miniaturized implantable loop recorder (ILR) is recommended. The aim of our study was to evaluate the efficacy of miniaturized cardiac implantable devices in the early diagnosis of arrhythmias in children ≤6 years. Methods From March 2014 to May 2015, 21 patients (median age 5 years) underwent implantation of miniaturized ILR at our Institution after a complete cardiac work up. Median follow‐up was 10 months. Results One patient underwent device removal for pocket infection and one needed a pocket revision. Eleven (52%) patients did not show any symptom and/or arrhythmia. Eight patients experienced symptoms during ILR monitoring: six had no electrocardiographic abnormalities, two had significant sinus pauses. Two patients had significant arrhythmias without symptoms and in one of these a pacemaker was implanted. The overall diagnostic yield was 47%. Conclusions Miniaturized ILR could be very useful to make a diagnosis and to decide future management strategies in small patients with undefined symptoms or severe cardiac diseases. Considering its characteristics, miniaturized ILR could start a new era in the diagnosis and follow‐up of young patients with symptomatic and/or malignant arrhythmias.