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Recurrent unexplained palpitations (RUP) study comparison of implantable loop recorder versus conventional diagnostic strategy.

Abstract：

OBJECTIVES:The aim of the study was to compare the diagnostic yield and the costs of implantable loop recorder (ILR) with those of the conventional strategy in patients with unexplained palpitations. BACKGROUND:In patients with unexplained palpitations, especially in those with infrequent symptoms, the conventional strategy, including short-term ambulatory electrocardiogram (ECG) monitoring and electrophysiological study, sometimes fails to establish a diagnosis. METHODS:We studied 50 patients with infrequent (< or =1 episode/month), sustained (>1 min) palpitations. Before enrollment, patients had a negative initial evaluation, including history, physical examination, and ECG. Patients were randomized either to conventional strategy (24-h Holter recording, a 4-week period of ambulatory ECG monitoring with an external recorder, and electrophysiological study) (n = 24) or to ILR implantation with 1-year monitoring (n = 26). Hospital costs of the 2 strategies were calculated. RESULTS:A diagnosis was obtained in 5 patients in the conventional strategy group, and in 19 subjects in the ILR group (21% vs. 73%, p < 0.001). Despite the higher initial cost, the cost per diagnosis in the ILR group was lower than in the conventional strategy group (euro 3,056 +/- euro 363 vs. euro 6,768 +/- euro 6,672, p = 0.012). CONCLUSIONS:In subjects without severe heart disease and with infrequent palpitations, ILR is a safe and more cost-effective diagnostic approach than conventional strategy.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Giada F,Gulizia M,Francese M,Croci F,Santangelo L,Santomauro M,Occhetta E,Menozzi C,Raviele A

doi

10.1016/j.jacc.2007.02.036

subject

Has Abstract

pub_date

2007-05-15 00:00:00

pages

1951-6

issue

19

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(07)00767-X

journal_volume

49

pub_type

杂志文章,多中心研究,随机对照试验

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