Arrhythmias common in patients with syncope
CHICAGO — Among patients with a history of syncope who had ambulatory ECG monitoring, nearly four of five had an arrhythmia, researchers reported at the American Heart Association Scientific Sessions.
“Patients with a history of syncope are at high risk for sudden death, with a reported 1-year mortality rate of 30%,” Bobbi Lynne Hoppe, MD, FACC, FHRS, electrophysiologist at Kittitas Valley Healthcare in Ellensburg, Washington, and colleagues wrote in an abstract. “Triaging relevant arrhythmias in a timely manner in this population is critical to allow for potential lifesaving interventions.”
Hoppe and colleagues conducted a retrospective analysis of 10,643 U.S. patients (mean age, 65 years; 49% women) with a history of syncope and an indication for monitoring. All patients had recordings with an ambulatory ECG monitoring system (Zio AT, iRhythm Technologies) for a mean of 11.9 days between July 2017 and December 2021.
Among the cohort, 79% had at least one arrhythmia detected, and 29% had at least two arrhythmia types detected, according to the researchers.
The most common arrhythmia types were supraventricular tachycardia (69%), ventricular tachycardia (26%) and atrial fibrillation (9.5%), Hoppe and colleagues found.
The rate of atrioventricular block was 3.6% and the rate of pause was 6.2%, according to the researchers.
AF/atrial flutter was the most common arrhythmia type to trigger a notification alert (8.5%), whereas among those who had AF, mean time to first AF detection was 1.4 days, and among those who had paroxysmal AF, mean time to first detection was 2.8 days, Hoppe and colleagues found.
“In this large retrospective study, ambulatory ECG monitoring with Zio AT in syncope-indicated patients revealed an unexpectedly high incidence of AF and supraventricular tachycardia,” Hoppe and colleagues wrote in the abstract. “Further analysis of this group may help clinicians focus a heightened awareness of atrial arrhythmias in this population.”
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Hoppe BL, et al. Abstract MO4131. Presented at: American Heart Association Scientific Sessions; Nov. 5-7, 2022; Chicago (hybrid meeting).