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Available from: Andrew Krahn, Aug 01, 2015
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    • "január közötti időszakból az összes olyan eset adatait elemeztük, ahol a syncope etiológiájának vizsgálata keretében implantálható loop recorder (ILR) beültetésére került sor. Syncopeként értékeltük a hirtelen kezdetű, néhány perc alatt maradéktalanul rendeződő, összeeséssel járó eszméletvesztést [7]. A kivizsgálási stratégia a kezelőorvosok hatáskörében az érvényes nemzetközi ajánlásokhoz igazodott, az ILR alkalmazása tekintetében lényegesen befolyásolva a vizsgálati módszer korlátozott hozzáférhetősége által. "
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    ABSTRACT: Extension of electrocardiographic monitoring via loop recorder implantation may increase the diagnostic yield of syncope work-up. In this retrospective observational study, the authors wanted to evaluate the diagnostic performance of implantable loop recorder in the everyday clinical practice. The authors analyzed the electronically stored data of all patients who underwent loop recorder implantation between 2005 and 2014 in their cardiology department because of recurrent syncope of undetermined origin. There were 52 loop recorder implantations within the study period. During the 167 (±136) days of monitoring, 36 (69.2%) diagnostic events occurred. In two-thirds of events, (46.2% of all monitored patients) a specific arrhythmia diagnosis was reached, allowing definitive treatment in these cases. In this selected population, there was no correlation between age, presence of known high-risk predictors, or accompanying trauma, and the mechanism of syncope. The high diagnostic rate of implantable loop recorder in the everyday clinical practice is in accordance with the findings in prospective clinical studies. This observation supports the early application of loop recorder in the diagnostic algorithm of syncope. Orv. Hetil., 2015, 156(15), 609-613.
    Orvosi Hetilap 04/2015; 156(15-15):609-613. DOI:10.1556/OH.2015.30124
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    • "Adenosine (AD) and adenosine triphosphate (ATP) administrations have long been proposed as potentially useful non-invasive diagnostic tools in patients with neurally-mediated or bradycardia-related syncope [2]. No consensus however has been reached in their use as study results have been inconclusive [1]. This article summarizes recent and past evidence in the use of both compounds in the diagnostic workup of patients with syncope and highlights the future perspectives of these agents in everyday clinical practice. "
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    ABSTRACT: Syncope is a significant source of cardiovascular-related morbidity yet the etiology is frequently obscure and the identification of patients at highest risk is challenging. Adenosine (AD) and adenosine triphosphate (ATP) administrations have been suggested as potentially useful non-invasive tools in the diagnostic workup of patients with neurally-mediated or bradycardia-related syncope. It has been postulated that both compounds by modulating the autonomic innervation in the heart and exerting negative chronotropic and dromotropic effects in the conduction system, may unmask the mechanism of syncope. However, the clinical implications derived from the efficacy of both tests in the investigation of syncope remain unclear mainly due to inconclusive and occasionally contradictory results of published studies. This review article summarizes recent and past information in the use of ATP and AD in the investigation of syncope with emphasis on clinical trials. We present the current level of evidence for the use of these agents in clinical practice, identify areas where further research is warranted and highlight the future perspectives of these agents as complements to an accurate risk-stratification of patients with syncope. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    International Journal of Cardiology 01/2015; 183C:267-273. DOI:10.1016/j.ijcard.2015.01.089 · 6.18 Impact Factor
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    • "Enquiries should extend to two or three generations, and in sensitive situations it may be best to ask whether any unexpected or unexplained tragedies have occurred in the family. For the purposes of risk stratification , national and international guidelines vary in their definition of a significant upper age limit for sudden cardiac death in a relative, with most recent United Kingdom guidance saying <40 years of age (Westby et al., 2010) and European guidance <30 years (Moya et al., 2009). "
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    ABSTRACT: Clinicians who diagnose and manage epilepsy frequently encounter diagnoses of a nonneurological nature, particularly when assessing patients with transient loss of consciousness (T-LOC). Among these, and perhaps the most important, is cardiac syncope. As a group, patients with cardiac syncope have the highest likelihood of subsequent sudden death, and yet, unlike sudden unexpected death in epilepsy (SUDEP) for example, it is the norm for these tragic occurrences to be both easily predictable and preventable. In the 12 months following initial presentation with cardiac syncope, sudden death has been found to be 6 times more common than in those with noncardiac syncope (N Engl J Med 309, 1983, 197). In short, for every patient seen with T-LOC, two fundamental aims of the consultation are to assess the likelihood of cardiac syncope as the cause, and to estimate the risk of future sudden death for the individual. This article aims to outline for the noncardiologist how to recognize cardiac syncope, how to tell it apart from more benign cardiovascular forms of syncope as well as from seizures and epilepsy, and what can be done to predict and prevent sudden death in these patients. This is achieved through the assessment triad of a clinical history and examination, risk stratification, and 12-lead electrocardiography (ECG).
    Epilepsia 12/2012; 53 Suppl 7:34-41. DOI:10.1111/j.1528-1167.2012.03713.x · 4.58 Impact Factor
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