Abstract

OLIVEIRA, Tiago dos Santos  and  FREITAS, João Pedro Pinto. Syncope Diagnosis. Medicina Interna [online]. 2019, vol.26, n.2, pp.126-134. ISSN 0872-671X.  https://doi.org/10.24950/rspmi/Revisao/63/18/2/2019.

In the diagnosis of patients with syncope it is important that the aetiology is correctly determined. Thus, a multidisciplinary approach is essential in the evaluation of these patients, combining a meticulous clinical history with an appropriate physical examination and auxiliary diagnostic tests. However, even with a correct initial approach, many patients are misdiagnosed or remain undiagnosed, becoming then candidates for a prolonged follow-up. The implantable loop recorder (ILR) is a small device that allows prolonged monitoring (up to 3 years) of the electric cardiac activity, increasing the likelihood of detecting a correlation between any cardiac rhythm alterations and the patient's symptoms. Thus, ILRs have assumed an increasing interest in this area since they allow the detection of cardiac (arrhythmic) aetiology of much syncope that until then remained with an unknown cause. The current guidelines recommend the use of ILRs in the early phase of the evaluation of patients with recurrent syncope of unknown cause, after initial evaluation, in the absence of high risk criteria and in the evaluation of high risk patients with syncope after initial negative evaluation. This article is a systematic review that summarizes the current knowledge about the utility and accuracy of ILR in the diagnosis of syncope of unknown cause after a conventional diagnostic approach; as well as its utility in many specific situations (epilepsy, paediatrics, elderly, atrial fibrillation and cryptogenic stroke).

Keywords : Diagnosis, Computer-Assisted; Monitoring, Ambulatory; Syncope/diagnosis.

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