Medtronic
 
 

Insertable
Loop Recorder

Transient Loss of Consciousness (TLOC) and Tachycardia with Paroxysmal Atrial Fibrillation


BACKGROUND

A 65-year-old male suffered recurrent syncopal episodes.  A review of his records showed:

  • Seven short episodes with loss of consciousness
  • History of exertional dyspnea (NYHA II) due to reduced left ventricular function following myocarditis
  • ACE inhibitor use (which improved his exertional dyspnea)
  • Ejection fraction of 40%

WORKUP

The patient went through a series of tests including:

  • Computer tomography of cerebrum, sonography of carotid arteries, and echocardiogram — all negative
  • ECG showed a permanent AV conduction delay of 230 ms with sinus rhythm
  • EP examination showed an HV interval extended to 62 ms at 750 ms sinus cycle length; neither supraventricular nor ventricular arrhythmias could be induced
  • Reveal ILR implant

CONCLUSION

Six months after the Reveal implant, the patient experienced another episode and lost consciousness for approximately 30 seconds.  Two recordings were captured and therapy followed.

  • One recording (Figure 1) showed ventricular tachycardia at a rate of 206 bpm with spontaneous termination


Figure 1: Ventricular Tachycardia

  • An additional recording (Figure 2) revealed paroxysmal atrial fibrillation


 Figure 2: Paroxysmal Atrial Fibrillation

Source: Lercher P, Brussee H, Rotman B, Klein W,
Clinical Department for Cardiology, Medical University Clinic; Graz, Austria

  • Medication-based therapy was initiated with amiodarone 
  • The patient has had no recurrent events

Data on file. Results may not be typical for every patient.

Additional Information