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28.11.2022 | Original Article

Clinical predictors of cardiac syncope in patients with unexplained syncope after the implantation of an insertable cardiac monitor

verfasst von: Kenji Matsumoto, Yuka Kodama, Shinji Ito, Yuka Nakamura, Ryosuke Fujiwara, Keiko Kajio, Keiko Kasamatsu, Eriko Murata, Yasuhiro Nakamura, Yoshio Kawase

Erschienen in: Heart and Vessels | Ausgabe 5/2023

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Abstract

Syncope prognosis is related to both its etiology and comorbidities, with cardiac syncope (CS) having higher risks for mortality and cardiovascular events than syncope of non-cardiac causes. Although a novel insertable cardiac monitor (ICM) is an effective diagnostic tool for unexplained syncope, decision regarding ICM implantation with a high pre-test likelihood of CS should contribute to economic cost reduction and avoidance of unnecessary complications. This study aimed to investigate clinical factors associated with CS after ICM implantation in patients with unexplained syncope. This retrospective observational study included 31 consecutive patients with ICM implantation for syncope between September 2016 and August 2021. The initial examinations for syncope included a detailed history, physical examination, blood tests, 12-lead electrocardiograms, and transthoracic echocardiography. Of the 31 patients, 13 (41.9%) experienced recurrent CS during follow-up (676 ± 469 days). Among several clinical factors, syncope-related minor injuries (p = 0.017) and higher brain natriuretic peptide (BNP; p = 0.043) levels were significantly associated with CS. Moreover, multivariable analysis showed that both syncope-related minor injuries (odds ratio, 11.2; 95% confidence interval, 1.4–88.4; p = 0.022) and BNP higher than 64.0 pg/mL (odds ratio, 7.0; 95% confidence interval, 1.1–44.2; p = 0.038) were independent predictors of CS after ICM implantation. In conclusion, a history of minor injury secondary to syncope and higher BNP levels were independent CS predictors in patients receiving ICM for syncope. These results emphasized the utility of ICM implantation early in the diagnostic journey of patients presenting with CS predictors requiring specific treatments.

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Titel: Clinical predictors of cardiac syncope in patients with unexplained syncope after the implantation of an insertable cardiac monitor
verfasst von: Kenji Matsumoto
Yuka Kodama
Shinji Ito
Yuka Nakamura
Ryosuke Fujiwara
Keiko Kajio
Keiko Kasamatsu
Eriko Murata
Yasuhiro Nakamura
Yoshio Kawase
Publikationsdatum: 28.11.2022
Verlag: Springer Japan
Erschienen in: Heart and Vessels / Ausgabe 5/2023
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-022-02212-x

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