Effektivität von subkutan implantierten Loop-Rekordern zur differentialdiagnostischen Abklärung von Synkopen und Herzrhythmusstörungen im Kindes- und Jugendalter

Effectiveness of subcutaneously implanted loop recorders for the differential diagnosis of syncope and cardiac arrhythmias in children and adolescents

by Christine Maaß
Doctoral thesis
Date of Examination:2025-12-11
Date of issue:2025-12-08
Advisor:PD Dr. Ulrich Krause
Referee:PD Dr. Ulrich Krause
Referee:Prof. Dr. Markus Zabel
Persistent Address: http://dx.doi.org/10.53846/goediss-11694

 

 

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Abstract

English

This dissertation is a single-center retrospective study that examines the effectiveness of subcutaneously implanted loop recorders for the differential diagnosis of syncope and cardiac arrhythmias in children and adolescents. The patient cohort consists of 52 children and adolescents who underwent implantation of a subcutaneous loop recorder for continuous recording of the cardiac rhythm between December 15th 2014 and December 10th 2021 at the Department of Pediatric Cardiology Intensive Care Medicine and Neonatology at Göttingen University Medical Center. Patients were included in this study at the time of implantation until they reached the age of 18. The indications for loop recorder implantation were recurrent syncope, recurrent unexplained states of emergency or recurrent palpitations. Only the Reveal LINQ LNQ11 from Medtronic was implanted. We were able to show that a total of 11/52 (21%) patients had a rhythmological cause for their symptoms, which was diagnosed using loop recorder. As a result, specific therapy for the documented cardiac arrhythmia could be offered. In addition, heart rhythm disorder could also be ruled out in some participants thus providing reassurance to their families. In patients with palpitations as an indication for loop recorder implantation, heart rhythm disorder was documented more frequently than in patients with other indications. In addition, heart rhythm disorder was documented more frequently in patients with structural heart defects than in patients with structurally normal hearts. With 57.7% of girls and 42.3% of boys, loop recorder implantation was slightly more common in girls than in boys. At the time of implantation, girls were significantly older than boys. The number of cardiac diagnoses detected, on the other hand, did not differ significantly between the sexes. A rhythmological diagnosis was made using LR in 20% of girls and 22.7% of boys. The complication rate was low at 3.8%. In summary, the implantation of a loop recorder in children and adolescents is very useful when indicated in order to obtain ECG recordings during symptoms and thus be able to make a well-founded diagnosis.
Keywords: Loop recorder; children and adolescents; syncope
Schlagwörter: Loop-Rekorder; Synkopen; Kinder- und Jugendliche
 
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