Long-term cardiac monitoring in older adults with unexplained falls and syncope
Open accessAbstract
AIMS: Unexplained falls account for 20% of falls in older cohorts. The role of the implantable loop recorder (ILR) in the detection of arrhythmias in patients with unexplained falls is unknown. We aimed to examine the diagnostic utility of the ILR in detection of arrhythmogenic causes of unexplained falls in older patients. METHODS: A single centre, prospective, observational cohort study of recurrent fallers over the age of 50 years with two or more unexplained falls presenting to an emergency department. Insertion of an ILR (Reveal, Medtronic, Minnesota, USA) was used to detect arrhythmia. The primary outcome was detection of cardiac arrhythmia associated with a fall or syncope. The secondary outcome was detection of cardiac arrhythmia independent of falls or syncope, and falls or syncope without associated arrhythmia. RESULTS: Seventy patients, mean age 70 years (51-85 years) received an ILR. In 70% of patients cardiac arrhythmias were detected at a mean time of 47.3 days (SD 48.25). In 20%, falls were attributable to a modifiable cardiac arrhythmia; 10 (14%) received a cardiac pacemaker, 4 (6%) had treatment for supraventricular tachycardia. Patients who had a cardiac arrhythmia detected were more likely to experience a further fall. CONCLUSIONS: 14 (20%) patients demonstrated an arrhythmia which was attributable as the cause of their fall. Patients who have cardiac arrhythmia are significantly more likely to experience future falls. Further research is important to investigate if early detection of arrhythmogenic causes of falls using the ILR prevents future falls in older patients.
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In patients with unexplained falls, an attack could have been documented by ILR in 70% of patients, with an arrhythmic cause being responsible in 14%.
“Patients with unexplained falls: in pooled data, an attack could have been documented by ILR in 70% of patients, with an arrhythmic cause being responsible in 14% 191-194”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [194]
The Arrhythmia and Discussion sections report ILR-detected arrhythmias in about 70% of this single-centre cohort, but that figure refers to arrhythmia detection, not documented fall attacks. The Discussion attributes falls to a modifiable arrhythmia in 20% of patients, not 14%; the Abstract uses 14% for patients who received a pacemaker. This paper alone also does not establish the citing sentence’s pooled-data estimate. (LLM, conf=0.88)
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Research works printed but not linked: 1
- Bhangu J, et al. Heart 2016;102:681-686. doi:10.1136/heartjnl-2015-308706 Arrhythmias and sudden death on August 20, 2023 by guest. Protected by copyright. http://heart.bmj.com/ Heart: first published as 10.1136/heartjnl-2015-308706 on 28 January 2016. Downloaded from REFERENCES
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- Authors
- Bhangu, J., McMahon, C. G., Hall, P., Bennett, K., Rice, C., Crean, P., Sutton, R., & Kenny, R.-A.
- Affiliations
- Trinity College Dublin (IE)
- St. James's Hospital (IE)
- Imperial College London (GB)
- Corresponding author
- Bhangu, Jaspreet
- ORCID
- Venue
- Heart
- Publisher
- BMJ
- Published
- 2016-01-28
- Volume
- 102
- Issue
- 9
- Pages
- 681-686
- ISSN
- 1355-6037 (ISSN-L)
- 1468-201X
- OpenAlex
- W2306270171
- Cited by
- 63
- References
- 27
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 4 · 2022: 6 · 2021: 3 · 2020: 6 · 2019: 6 · 2018: 11 · 2017: 11 · 2016: 8
- FWCI
- 13.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Heart (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- unexplained falls, syncope, implantable loop recorder, cardiac arrhythmias, older adults, recurrent falls, fall prevention, supraventricular tachycardia, cardiac pacemaker
- MeSH terms
- Accidental Falls, Aged, Aged, 80 and over, Arrhythmias, Cardiac, Electrodes, Implanted, Female, Humans, Long-Term Care, Male, Middle Aged, Prospective Studies, Recurrence, Syncope, Electrocardiography, Ambulatory
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