The implantable loop recorder in children. Issue 7 (30th July 2007)

• Record Type: Journal Article
• Authors: Yeung, B; McLeod, K
• Is Part Of: Heart. Volume 94:Issue 7(2008)
• Page Start: 888
• Page End: 891
• Publication Date: 2007-07-30
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2007.121855
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objective: To evaluate use of the implantable loop recorder in children. Setting: Royal Hospital for Sick Children, Glasgow, UK. Method: Retrospective study of children who had an implantable loop recorder between September 1998 and October 2005. Results: 38 devices were implanted in 34 children. Median age at implantation 11.3 years (range 1.8–17.6); median follow-up period 15 months (range 2–58). The main presenting complaint was syncope in 26 (76.5%), seizures in 6 (17.6%) and palpitations in 2 (5.9%). After implantation, 19 (55.9%) patients had symptom recurrence. Of these, 11 were shown to have sinus rhythm during symptoms and 8 had an abnormal ECG. Four patients had asystole >3 seconds and were diagnosed with reflex asystolic syncope; 2 had polymorphic ventricular tachycardia. One patient who already had a diagnosis of long QT syndrome was shown to have ventricular ectopy during symptoms and β-blockers were increased. One patient had transient complete heart block during symptoms but refused a pacemaker. In almost half the patients (44.1%), symptoms resolved after implantation. Complications requiring removal of the device occurred in 6 (15.8%) implants. Conclusions: In children with syncope and palpitations, the implantable loop recorder appears to be an excellent method of effecting a "cure" in almost 50% of subjects. For those who remain symptomatic, it is successful in determining cardiac rhythm during symptoms, but the complication rate in children may be higher than that of adults.