Syncope and implantable loop recorders: Good value for money?
Sep 1, 2009 - 4:00:00 AM
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Previous scientific studies, mainly from the United Kingdom, have shown that up to 1 in 4 patients thought to be suffering from epilepsy do not actually have this condition. This conclusion was based on reviewing medical records of patients known to have epilepsy and on the results of the tilt table test, a test in which patients are made to stand at an angle of 60 degrees on a bed with a footboard support in an attempt to induce a blackout. Moreover, the All Party Parliamentary Group on Epilepsy, in their report published in June 2007, found that 74,000 patients in the United Kingdom were taking drugs for epilepsy, which they did not need. Patients with syncope (fainting) as well as epilepsy present with transient loss of consciousness (T-LOC) or 'blackouts'. In some patients syncope (fainting) can mimic epilepsy. A temporary decrease in blood supply to the brain which occurs in syncope (fainting) can result in irritation of brain cells causing abnormal movements, which to a lay person can look very similar to epilepsy. In the general population, syncope (fainting) is much more common than epilepsy, affecting 25% of the population at any given time, more so in the elderly.
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By European Society of Cardiology,
[RxPG] Barcelona, Spain, 1 September 2009: The REVISE Study (Reveal in the Investigation of Syncope and Epilepsy) found that 1 in 8 adult patients in the United Kingdom, previously thought to be suffering from epilepsy or in whom this diagnosis was in doubt, in fact had symptoms as a result of an abnormal pattern of heart beating, commonly found in patients with syncope (fainting).
REVISE is the first study to show that, by means of an implantable ECG recorder, 1 in 8 patients who were previously thought to have epilepsy or in whom this diagnosis was in doubt, have an abnormality in their heart rhythm as a cause of their symptoms. Eighty percent of those who underwent a pacemaker insertion based on the results of the ECG loop recorder were subsequently found to be free of their symptoms.
Four of the 5 patients who underwent a pacemaker as part of this study were subsequently free of symptoms. The average duration of follow-up was 9 months. This study was carried out at the Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK in collaboration with the Greater Manchester Centre for Neurosciences, Hope Hospital, Salford, UK. A small metallic device * about the size of a memory stick or a packet of gum, was used to record the heart rhythm of patients in this study. This device was inserted underneath the skin, on the left side of the chest in a small, low risk, 20 minute operation. Study patients also underwent a number of other brain and heart tests.
Previous scientific studies, mainly from the United Kingdom, have shown that up to 1 in 4 patients thought to be suffering from epilepsy do not actually have this condition. This conclusion was based on reviewing medical records of patients known to have epilepsy and on the results of the tilt table test, a test in which patients are made to stand at an angle of 60 degrees on a bed with a footboard support in an attempt to induce a blackout. Moreover, the All Party Parliamentary Group on Epilepsy, in their report published in June 2007, found that 74,000 patients in the United Kingdom were taking drugs for epilepsy, which they did not need. Patients with syncope (fainting) as well as epilepsy present with transient loss of consciousness (T-LOC) or 'blackouts'. In some patients syncope (fainting) can mimic epilepsy. A temporary decrease in blood supply to the brain which occurs in syncope (fainting) can result in irritation of brain cells causing abnormal movements, which to a lay person can look very similar to epilepsy. In the general population, syncope (fainting) is much more common than epilepsy, affecting 25% of the population at any given time, more so in the elderly.
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