Patient - EN
A 62-year-old woman suffered a possible episode of syncope while driving, complicated by a car accident. All diagnostic tests were normal, including an echocardiogram and an ECG, which showed a narrow QRS. Because of the seriousness and consequences of the accident, a Reveal DX was implanted after this first and only episode.
Graph and trace
The report from home monitoring revealed neither automatically nor patient-activated recording of an event
NID old - EN
3128
Syncope while driving might be challenging to diagnose and manage, since it may be difficult to distinguish falling asleep from losing consciousness, and since the consequences may be catastrophic. A large proportion of patients suffer no recurrence during the life of the implanted device. This can only be helped by a) increasing the pre-implant likelihood of a recurrent event, and b) increasing the life expectancy of the device’s batteries. In this patient, the pre-implant probability that she would suffer a recurrence was low, as she had suffered a single event, the characteristics of which were unclear. The strictly normal clinical investigations, ECG and echocardiogram suggested a very low risk of syncope of cardiac origin. Furthermore, the history did not suggest a vagally-mediated event. Thus, the implantation of an ILR was justified by the consequences of the episode and by the risk incurred by the patient, rather than by the clinical presentation. The batteries of the newest devices can last up to 36 months. It is often important to wait long enough for a recurrence, since the longer the monitoring, the higher the likelihood of diagnosis.