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Diagnostic OPTIONS
If your doctor suspects that your fainting is heart-related, cardiac monitoring may be necessary. Cardiac monitoring is used to either identify or rule out a heart rhythm disorder and to determine an appropriate course of treatment. The type of cardiac monitor used is often determined by the frequency of your faints. If your faints occur often and a few days apart a holter may be useful. If your faints are separated by weeks or months a longer monitor such as an event recorder or insertable cardiac monitor may be more appropriate1. Common types of cardiac monitoring systems include:
A portable external monitor that includes wires with patches that attach to the skin. It continuously measures and records the heart’s activity for 1-2 days. It is best suited for very frequent faints that occur often and typically a few days apart.1-4
A recorder worn on the body for up to 30 days.1-4 It typically requires activation by pushing a button to record the heart’s activity. Best suited for fainting that occurs every few weeks.
Placed just under the skin during a minimally invasive procedure, it automatically detects and records abnormal heart rhythms for up to 4.5 years. It is best suited for fainting that occurs less frequently. For example, once a month. 1-4
Insertion of an insertable cardiac monitor typically takes less than five minutes. It does not require general anaesthesia. The monitor is placed just under the skin.
You will return home with a transmitter, which is used to send information from your heart monitor to your doctor.
Your doctor’s office will get personalised information with recordings of any abnormal heartbeats.
1 Brignole M, etal. 2018 ESC Guidelines for the diagnosis and management of syncope, European Heart Journal, Volume 39, Issue 21, 01 June 2018, Pages 1883–1948, https://doi.org/10.1093/eurheartj/ehy037.
2 Shen WK. et al. 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm. 2017 Aug;14(8):e155-e217. doi: 10.1016/j.hrthm.2017.03.004. Epub 2017 Mar 9. PMID: 28286247
3 Brignole M, et al. 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Eur Heart J. 2013 Aug;34(29):2281-329. doi: 10.1093/eurheartj/eht150. Epub 2013 Jun 24. PMID: 23801822.
4 National Institute for Health and Clinical Excellence, Transient loss of consciousness ('blackouts') in over 16s, Clinical Guideline [CG109], Published date: 25 August 2010 Last updated: 01 September 2014, www.nice.org.uk.
5 Morag R, Brenner B. Syncope. Medscape. April 16, 2014. Accessed February 16, 2018.