Evidence map›Paper›PMID 32621215›Full record

ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2021

The diagnostic yield of implantable loop recorders stratified by indication: "real-world" use in a large academic hospital.

Alexander Smith, Makenzie Perdue, Jetmir Vojnika, Daniel R Frisch, Behzad B Pavri

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Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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5citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Alexander SmithDepartment of Medicine, Thomas Jefferson University Hospital, 111 South 11th Street, Philadelphia, PA, USA.
Makenzie PerdueDepartment of Medicine, Thomas Jefferson University Hospital, 111 South 11th Street, Philadelphia, PA, USA.
Jetmir VojnikaDepartment of Medicine, Thomas Jefferson University Hospital, 111 South 11th Street, Philadelphia, PA, USA.
Daniel R FrischDepartment of Medicine, Thomas Jefferson University Hospital, 111 South 11th Street, Philadelphia, PA, USA.
Behzad B PavriDepartment of Medicine, Thomas Jefferson University Hospital, 111 South 11th Street, Philadelphia, PA, USA. behzad.pavri@Jefferson.edu.ORCID http://orcid.org/0000-0003-1240-7812

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo report on the clinical utility of implantable loop recorders (ILRs) in a large academic hospital setting over a 4-year period.

methodsRetrospective study (2013-2016) of patients receiving ILRs for any indication including syncope, cryptogenic stroke (CrS), atrial fibrillation (AF) burden, palpitations, ventricular arrhythmias (VA), and other. Remote checks, symptomatic transmissions, and in-person checks were reviewed. Time to diagnosis was documented.

resultsA total of 263 patients (54% male, mean age 63 ± 15 years, mean follow-up 601 (range 9-1714) days) received ILRs for 324 indications; multiple indications were noted in 53/263 (20.2%) patients. ILR indications were 126 (39%) syncope, 81 (25%) CrS, 46 (14%) AF, 37 (11%) palpitations, 10 (3%) VA, and 24 (7%) other. Diagnostic yield for each indication was compared to the overall yield for all other indications. Three indications showed a significantly higher yield: AF (65% vs. 22%, p < 0.002), palpitations (60% vs. 24%, p < 0.001), and VA (70% vs. 28%, p < 0.004). For all other indications, there were no significant differences. Syncope had nearly half the diagnostic yield of previously published trials (28% vs. 43-56%). We observed a fourfold increase in ILR implant rate over the study duration.

conclusionsIn a "real-world" academic hospital setting, the diagnostic rate of ILRs was highest for AF, palpitations, and VA; however, these high yield indications comprised only 29% of all indications. The diagnostic yield for the commonest indication (syncope) was approximately half that reported in the previously published trials. With increasing implantation rates, additional studies are required to refine guideline-based indications for ILR implantation to improve diagnostic yield.

Indexed as

Atrial FibrillationElectrocardiography, AmbulatoryFemaleHospitalsHumansInfant, NewbornMaleRetrospective StudiesSyncopeDiagnostic yieldILRImplantable loop recordersSyncope

Identifiers

PMID32621215

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.