Cristian Podoleanu1, Antoine DaCosta2, Pascal Defaye3, Jérôme Taieb4, Daniel Galley5, Paul Bru6, Philippe Maury7, Philippe Mabo8, Serge Boveda9, Gilles Cellarier10, Frédéric Anselme11, Claude Kouakam12, Nicolas Delarche13, Jean-Claude Deharo14. 1. University of Medicine and Pharmacy, Târgu Mures, Romania. 2. CHU Nord, Saint-Étienne, France. 3. CHU La Tronche, Grenoble, France. 4. Centre hospitalier Aix-en-Provence, Aix-en-Provence, France. 5. Centre hospitalier Albi, Albi, France. 6. Centre hospitalier La Rochelle, La Rochelle, France. 7. CHU Rangueil, Toulouse, France. 8. CHU Pontchaillou, Rennes, France. 9. Clinique Pasteur, Toulouse, France. 10. HIA Sainte-Anne, Toulon, France. 11. CHU Charles-Nicolle, Rouen, France. 12. CHRU de Lille, Lille, France. 13. Centre hospitalier Pau, Pau, France. 14. Cardiologie 9(e) étage, CHU La Timone, 263, rue Saint-Pierre, 13385 Marseille cedex 5, France. Electronic address: jean-claude.deharo@ap-hm.fr.
Abstract
BACKGROUND: The role of implantable loop recorders (ILRs) in the evaluation strategy for recurrent syncope in France is limited by lack of knowledge of the cost. AIM: To compare a conventional evaluation strategy for syncope with the early use of an ILR in low-risk patients, in terms of diagnostic yield, cost and impact on quality of life (QoL). METHODS: National prospective randomized open-label multicenter study of patients with a single syncope (if severe and recent) or at least two syncopes in the past year. RESULTS:Seventy-eight patients (32 men) were randomized to the ILR strategy (ILR group, n=39) or the conventional evaluation strategy (CONVgroup, n=39): mean age 66.2±14.8 years; 4.3±6.4 previous syncopes. After 14 months of follow-up, a certain cause of syncope was established in 18 (46.2%) patients in the ILR group and two (5%) patients in the CONV group (P<0.001). Advanced cardiological tests were performed less frequently in the ILR group than in the CONV group (0.03±0.2 vs. 0.2±0.5 tests per patient; P=0.05). Patients in the ILR group were hospitalized for a non-significantly shorter period than patients in the CONV group (5.7±3.2 vs. 8.0±1.4 days). There was no difference between the two groups in terms of QoL main composite score. CONCLUSION: In patients with unexplained syncope, the early use of an ILR has a superior diagnostic yield compared with the conventional evaluation strategy, with lower healthcare-related costs.
RCT Entities:
BACKGROUND: The role of implantable loop recorders (ILRs) in the evaluation strategy for recurrent syncope in France is limited by lack of knowledge of the cost. AIM: To compare a conventional evaluation strategy for syncope with the early use of an ILR in low-risk patients, in terms of diagnostic yield, cost and impact on quality of life (QoL). METHODS: National prospective randomized open-label multicenter study of patients with a single syncope (if severe and recent) or at least two syncopes in the past year. RESULTS: Seventy-eight patients (32 men) were randomized to the ILR strategy (ILR group, n=39) or the conventional evaluation strategy (CONV group, n=39): mean age 66.2±14.8 years; 4.3±6.4 previous syncopes. After 14 months of follow-up, a certain cause of syncope was established in 18 (46.2%) patients in the ILR group and two (5%) patients in the CONV group (P<0.001). Advanced cardiological tests were performed less frequently in the ILR group than in the CONV group (0.03±0.2 vs. 0.2±0.5 tests per patient; P=0.05). Patients in the ILR group were hospitalized for a non-significantly shorter period than patients in the CONV group (5.7±3.2 vs. 8.0±1.4 days). There was no difference between the two groups in terms of QoL main composite score. CONCLUSION: In patients with unexplained syncope, the early use of an ILR has a superior diagnostic yield compared with the conventional evaluation strategy, with lower healthcare-related costs.
Authors: Dariusz Dudek; Waldemar Banasiak; Wojciech Braksator; Jacek Dubiel; Tomasz Grodzicki; Piotr Hoffman; Mariusz Kuśmierczyk; Grzegorz Opolski; Piotr Ponikowski; Jacek Różański; Jerzy Sadowski; Wojciech Wojakowski; Marcin Grabowski; Katarzyna Bondaryk; Jacek Walczak; Izabela Pieniążek; Maciej Grys; Anna Lesiak-Bednarek; Piotr Przygodzki Journal: Cardiol J Date: 2019-02-14 Impact factor: 2.737
Authors: Florian Blaschke; Philipp Lacour; Thula Walter; Alexander Wutzler; Martin Huemer; Abdul Parwani; Philipp Attanasio; Leif-Hendrik Boldt; Marcus Markowski; Timm Denecke; Wilhelm Haverkamp Journal: Ann Noninvasive Electrocardiol Date: 2015-12-24 Impact factor: 1.468
Authors: Monica Solbiati; Giorgio Costantino; Giovanni Casazza; Franca Dipaola; Andrea Galli; Raffaello Furlan; Nicola Montano; Robert Sheldon Journal: Cochrane Database Syst Rev Date: 2016-04-19