Implanting a Loop Recorder

Episodes of syncope over the course of a 24-h Holter monitoring are rare. The vast majority of patients have a syncope-free interval, which can be measured in weeks, months, or years, but not days; therefore, symptom-ECG correlation is seldom achieved with Holter monitoring. In an overview [1] of the results of eight studies of ambulatory monitoring in syncope, only 4% of patients (range between 1 and 20%) had a correlation of symptoms with arrhythmia. The true yield of conventional ECG monitoring in syncope may be as low as 1–2% in an unselected population.