A 66-year-old man underwent implantation of a Reveal XT for recurrent syncope without apparent precipitating cause. An ECG and echocardiogram were normal.
An episode was recorded automatically and transmitted via telemedicine.
The automatic recording of episodes of bradycardia or tachycardia increases the diagnostic yield of the ILR. The asymptomatic and symptomatic episodes occurring in patients incapable of triggering the system are, therefore, memorised.
However, an important limitation of this function is the frequent spurious recording of a) bradycardia due to undersensing of ventricular signals, or b) tachycardia due to the sensing of noise, other cardiac signals, such as P or T waves or double counting of the R wave.
This implies a verification of all episodes stored in the device’s memory. Spurious arrhythmic episodes are recorded in >75% of ILR recipients.
The device diagnosed bradycardia. The low bradycardia rate is indeed <30 bpm (>2000 ms). Sensing was programmed at 0.025 mV.
