Clinical characteristics associated with bradycardia and asystole in patients with syncope undergoing long-term electrocardiographic monitoring with implantable loop recorder

Abstract

In patients undergoing ILR implantation bradycardia is a frequent finding despite the negative conventional diagnostic testing. Absence of prodromal symptoms, male gender and age >65 years are risk factors for bradycardia and pacemaker implantation.

Predictors of pacemaker requirement in patients with implantable loop recorder and unexplained syncope: A systematic review and meta‐analysis

“…These modifications, particularly those near the atrium tissue, inhibit sinus node impulsion activity which is manifested as a prolonged PR interval in the EKG 41 . Previous clinical studies demonstrate that abnormalities at atrium level namely AF, first degree atrioventricular block, and elongated PR interval increase the risk of recurrent syncope with the need for pacing device implantation which is concurrent with our result 12,22,26,27 …”

“…41 the risk of recurrent syncope with the need for pacing device implantation which is concurrent with our result. 12,22,26,27 Sinus bradycardia was found to be a major predictive factor of pacing requirement based on our analysis which is the most common arrhythmia seen in individuals with unexplained syncope during ILR monitoring. Similar to other atrial dysfunction related complications, based on clinical and observational studies, sinus bradycardia is affiliated with reduction of heart rate mostly through SND or disturbances in cardiac conduction system which necessitates the need for pacemaker implantation.…”

“…Finally, 5 prospective 12,21-24 and 5 retrospective [25][26][27][28][29] observational studies were included.…”

“…Only a few studies have identified HTN as a risk factor for the implantation of pacing devices, however HTN was more prevalent among patients that required pacemaker implantation according to data from other studies. 12,23,25,26,29,50 Reyhane Yahya and Shayan Bastami: performed quality assessment.…”

“…HTN, similar to diabetes was found to be an insignificant independent predictive factor for pacemaker implantation. Only a few studies have identified HTN as a risk factor for the implantation of pacing devices, however HTN was more prevalent among patients that required pacemaker implantation according to data from other studies 12,23,25,26,29,50 . it's important to note that, based on the SPRINT trial, among hypertensive patients, aggressive HTN treatment compared to standard treatment was more associated with the occurrence of syncope 51 .…”