Miniaturized Implantable Loop Recorder in Small Patients: An Effective Approach to the Evaluation of Subjects at Risk of Sudden Death

Silvia Placidi, Fabrizio Drago, Maddalena Milioni, Letizia Verticelli, Ilaria Tamburri, Massimo Stefano Silvetti, Corrado Di Mambro, Daniela Righi, Fabrizio Gimigliano, Mario Salvatore Russo, Rosalinda Palmieri, Romolo Remoli, Lorenzo Maria Santucci, Alberto Eugenio Tozzi

Research output: Contribution to journalArticlepeer-review


Background: The etiological diagnosis of syncope and/or palpitations in children is often challenging. However, when noninvasive conventional examinations are inconclusive, the subcutaneous miniaturized implantable loop recorder (ILR) is recommended. The aim of our study was to evaluate the efficacy of miniaturized cardiac implantable devices in the early diagnosis of arrhythmias in children ≤6 years. Methods: From March 2014 to May 2015, 21 patients (median age 5 years) underwent implantation of miniaturized ILR at our Institution after a complete cardiac work up. Median follow-up was 10 months. Results: One patient underwent device removal for pocket infection and one needed a pocket revision. Eleven (52%) patients did not show any symptom and/or arrhythmia. Eight patients experienced symptoms during ILR monitoring: six had no electrocardiographic abnormalities, two had significant sinus pauses. Two patients had significant arrhythmias without symptoms and in one of these a pacemaker was implanted. The overall diagnostic yield was 47%. Conclusions: Miniaturized ILR could be very useful to make a diagnosis and to decide future management strategies in small patients with undefined symptoms or severe cardiac diseases. Considering its characteristics, miniaturized ILR could start a new era in the diagnosis and follow-up of young patients with symptomatic and/or malignant arrhythmias.

Original languageEnglish
Pages (from-to)669-674
Number of pages6
JournalPACE - Pacing and Clinical Electrophysiology
Issue number7
Publication statusPublished - Jul 1 2016


  • arrhythmias
  • children
  • implantable loop recorder
  • palpitations
  • syncope

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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