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The Role of External Loop Recorders in Arrhythmia-Related Symptoms in Children: A Single Center Experience

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Abstract

In this study, we report our experience with the use of external loop recorders (ELRs), in terms of diagnostic efficiency according to symptoms and symptom-rhythm correlation in pediatric patients. We evaluated ELRs applied to 178 patients between April 2017 and November 2020 at our center. The mean age of 172 patients included in the study was 13.6 ± 3.8 years, and 69.8% were female. ELR indications were palpitations in 98 (56.9%) cases, chest pain and palpitations in 43 (25%) cases, presyncope/syncope in 28 (16.2%) cases, and pacemaker/ implantable cardioverter-defibrillator (ICD) problems in 3 (0.2%) cases. ELR recording times were 14.2 ± 9.7 days on average, ranging from 2 to 67 days. While the symptom-rhythm correlation was 29.1% in total, when the indications were evaluated one by one, this correlation was found to be 30.2% in palpitations, 34.7% in chest pain and palpitations, and 10.7% in presyncope/syncope. The total diagnostic efficiency was 68.1%. In the follow-up of ELR cases, a total of 139 (80.8%) patients received clinical follow-up without medication, 15 (8.8%) patients received medical treatment, and 18 (10.4%) patients underwent EPS. The cardiac ELR system is useful in detecting underlying arrhythmias. Demonstrating sinus tachycardia at the time of the symptom may be seen as negative finding, but while experiencing symptoms, it is diagnostically valuable and may help avoid further investigation with costly and invasive diagnostic procedures. For diagnostic efficiency and cost effectiveness, the optimal recording time is 2 weeks, but it should be extended to 4 weeks in cases such as of presyncope/syncope that cannot be explained with a 2-week ELR use.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Pediatric Cardiology, Bursa Uludag University, Gorukle Campuss, Nilufer, Bursa, Turkey

    Tugberk Akca, Fahrettin Uysal, Ozlem Mehtap Bostan, Abdusselam Genc & Hasan Turkmen

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  1. Tugberk Akca
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  2. Fahrettin Uysal
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  3. Ozlem Mehtap Bostan
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  4. Abdusselam Genc
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  5. Hasan Turkmen
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Correspondence to Tugberk Akca.

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The authors declare that all the procedures that contributed to this work were carried out in compliance with the ethical standards of the relevant national guidelines on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008, and were approved by the relevant institutional committees.

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Akca, T., Uysal, F., Bostan, O.M. et al. The Role of External Loop Recorders in Arrhythmia-Related Symptoms in Children: A Single Center Experience. Pediatr Cardiol 43, 147–154 (2022). https://doi.org/10.1007/s00246-021-02705-y

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  • DOI: https://doi.org/10.1007/s00246-021-02705-y

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