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Diagnostic yield of the implantable loop recorder in octogenarians

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Abstract

Background/objectives

Syncope in octogenarians represents an important problem in terms of comorbidity, quality of life and substantial medical costs, resulting from studies and treatments. An implantable loop ecorder (ILR) may improve diagnostic performance. The objective of the study was to evaluate the results of the ILR in a population of octogenarians.

Design

Prospective registry of patients receiving an implantable loop recorder in 40 Spanish centers.

Participants

128 octogenarians implanted with a device for clinical evaluation of syncope.

Methods

Prospective registry recording the incidence of new symptoms or device activations within the first year after the implant, the incidence of new diagnosis and treatments, and an evaluation of the safety of this strategy in this population. Dedicated database for the registry.

Results

Forty-two patients (33% of the population) obtained a final etiological diagnosis of the syncope, which led to a specific treatment in 39 (31%) patients. No differences regarding the presence of conduction disturbances or structural heart disease were found in this population. A mortality of 4% was recorded during follow-up.

Conclusion

The implantable loop recorder seems to be an effective and safe tool in the management of syncope in the octogenarian population.

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Acknowledgements

I, the corresponding author, affirm that I have listed everyone who contributed significantly to the work and have obtained written consent from all non-author contributors who are named in the acknowledgment section. The authors thank María Corrales for their technical assistance in the translation of the final manuscript. Spanish Reveal Registry: Participating centers and investigators: Clínica Universitaria de Navarra (Ignacio García-Bolao), Complejo Hospitalario de Jaén (Miguel Ángel Arias), Fundación Hospital Son Llatzer (Tomás Ripoll-Vera), Hospital Xeral de Vigo (Xulio Beiras), Hospital 12 de Octubre (Fernando Arribas/María López-Gil), Hospital Arnau de Vilanova (José Sotillo), Hospital Clínico de Valencia (Ricardo Ruiz-Granell), Hospital Clínico San Carlos (Julián Villacastín), Hospital Costa del Sol (Francisco Ruiz-Mateas), Hospital de Basurto/Clínica Vicente San Sebastián (Jesús Martínez-Alday/María Fe Arcocha), Hospital De Donostia (Rafael Telleria), Hospital De Fuenlabrada (Alejandro Curcio), Hospital De León (Marisa Fidalgo), Hospital de Mérida (Javier Tejada-Ruiz), Hospital de Orense (José Miguel Martínez-Escauriaza Alonso), Hospital de Santiago (José Luis Martínez-Sande), Hospital de Tortosa (I. Lechuga), Hospital de Valme (Mª Dolores García-Medina), Hospital De Zafra (Francisco Andrade), Hospital del Mar (Julio Martí), Hospital Francisco de Borja (Plácido Orosa/Cathelyne Lawers), Hospital General de Albacete (Jesús F. García Sacristán), Hospital General De Castellón (Alejandro Navarro), Hospital General De Ciudad Real (Juan Benezet), Hospital General Yagüe (Javier García/Javier Martín), Hospital Gregorio Marañón (Felipe Atienza), Hospital Juan Canalejo (Luisa Pérez), Hospital Juan Ramón Jiménez (Rafael Barba-Pichardo), Hospital Marques de Valdecilla (Susana González), Hospital Puerta De Hierro (Jorge Toquero), Hospital Puerta del Mar (Lucas Cano), Hospital Ramón y Cajal (Antonio Hernández-Madrid), Hospital Río Hortega (Benito Herreros/Juan Francisco Muñoz), Hospital San Pedro de Alcántara (J. M. Larrazabal Murillo), Hospital Universitario de Canarias (Aníbal Rodríguez), Hospital Universitario de Getafe (Agustín Pastor), Hospital Universitario Infanta Cristina (Juan José García-Guerrero), Hospital Universitario La Paz (José Luis Merino-Llorens), Hospital Universitario Vall D’hebron (Ángel Moya), Hospital Virgen De La Arrixaca (Arcadio García-Alberola, Francisco J. Lacunza Ruiz), Hospital Virgen De La Macarena (Ernesto Díaz), Hospital Virgen De La Victoria (Javier Alzueta), Hospital Virgen del Rocío (Eduardo Arana).

Funding

Medtronic Ibérica collaborated with the design and maintenance of the Registry database. This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

Author information

Authors and Affiliations

  1. University Hospital Virgen de la Arrixaca, Ctra Madrid Cartagena sn. El Palmar, 30120, Murcia, Spain

    Francisco J. Lacunza-Ruiz & Arcadi García-Alberola

  2. University Hospital Vall d´Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain

    Angel Moya-Mitjans

  3. Hospital de Basurto/Clínica Vicente San Sebastian, Bilbao, Spain

    Jesús Martínez-Alday

  4. Hospital Virgen del Rocío, Seville, Spain

    Gonzalo Barón-Esquivias

  5. Hospital Clínico de Valencia, Valencia, Spain

    Ricardo Ruiz-Granell

Authors
  1. Francisco J. Lacunza-Ruiz
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  2. Angel Moya-Mitjans
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  3. Jesús Martínez-Alday
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  4. Gonzalo Barón-Esquivias
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  5. Ricardo Ruiz-Granell
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  6. Arcadi García-Alberola
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Consortia

the investigators of the Spanish Reveal Registry

  • Ignacio García-Bolao
  • , Miguel Ángel Arias
  • , Tomás Ripoll-Vera
  • , Xulio Beiras
  • , Fernando Arribas
  • , María López-Gil
  • , José Sotillo
  • , Ricardo Ruiz-Granell
  • , Julián Villacastín
  • , Francisco Ruiz-Mateas
  • , Jesús Martínez-Alday
  • , María Fe Arcocha
  • , Rafael Telleria
  • , Alejandro Curcio
  • , Marisa Fidalgo
  • , Javier Tejada-Ruiz
  • , José Miguel Martínez-Escauriaza Alonso
  • , José Luis Martínez-Sande
  • , I. Lechuga
  • , M. Dolores García-Medina
  • , Francisco Andrade
  • , Julio Martí
  • , Plácido Orosa
  • , Cathelyne Lawers
  • , Jesús F. García Sacristán
  • , Alejandro Navarro
  • , Juan Benezet
  • , Javier García
  • , Javier Martín
  • , Felipe Atienza
  • , Luisa Pérez
  • , Rafael Barba-Pichardo
  • , Susana González
  • , Jorge Toquero
  • , Lucas Cano
  • , Antonio Hernández-Madrid
  • , Benito Herreros
  • , Juan Francisco Muñoz
  • , J. M. Larrazabal Murillo
  • , Aníbal Rodríguez
  • , Agustín Pastor
  • , Juan José García-Guerrero
  • , José Luis Merino-Llorens
  • , Ángel Moya
  • , Arcadio García-Alberola
  • , Francisco J. Lacunza Ruiz
  • , Ernesto Díaz
  • , Javier Alzueta
  •  & Eduardo Arana

Contributions

All authors participated in the study design, data gathering, analysis and interpretation. Francisco J. Lacunza-Ruiz and Arcadi García-Alberola prepared the manuscript that was subsequently approved in its final version by the other authors.

Corresponding author

Correspondence to Francisco J. Lacunza-Ruiz.

Ethics declarations

Conflict of interest

The authors have no commercial associations or sources of support that might pose a conflict of interest. The authors declare not to have non-financial conflicts of interest. Their personal opinions are not in conflict with the data reported in the paper. Besides, none of them are members or are affiliated to any non-governmental organizations that may have an interest in the submission.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional research committee and the 1964 Helsinki Declaration, and its later amendments or comparable ethical standards.

Informed consent

Written informed consent for device implant and follow-up was obtained in all cases.

Additional information

The members of Spanish Reveal Registry are listed in Acknowledgements.

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Lacunza-Ruiz, F.J., Moya-Mitjans, A., Martínez-Alday, J. et al. Diagnostic yield of the implantable loop recorder in octogenarians. Eur Geriatr Med 10, 129–133 (2019). https://doi.org/10.1007/s41999-018-0128-1

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  • DOI: https://doi.org/10.1007/s41999-018-0128-1

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