Psychological Aspects of Syncopes and Possible Association with Recurrency—The Role of Implantable Loop Recorders
Syncopes are a very common phenomenon and have a high recurrence rate. The differentiation between the psychogenic and physical, especially of arrhythmic origin, remains difficult. In many cases, an implantable loop recorder is used for the detection of possible arrhythmias, leading to syncopes. Yet...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/8/1219 |
| _version_ | 1797432001903460352 |
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| author | Kevin Willy Christian Ellermann Sarah Syring Benjamin Rath Florian Reinke Daniela Willy Julian Wolfes Felix K. Wegner Lars Eckardt Julia Köbe Nexhmedin Morina |
| author_facet | Kevin Willy Christian Ellermann Sarah Syring Benjamin Rath Florian Reinke Daniela Willy Julian Wolfes Felix K. Wegner Lars Eckardt Julia Köbe Nexhmedin Morina |
| author_sort | Kevin Willy |
| collection | DOAJ |
| description | Syncopes are a very common phenomenon and have a high recurrence rate. The differentiation between the psychogenic and physical, especially of arrhythmic origin, remains difficult. In many cases, an implantable loop recorder is used for the detection of possible arrhythmias, leading to syncopes. Yet, the existing literature suggests that psychological factors may play a significant role in recurrent syncopes. We aimed at analyzing the potential role of several psychological factors on the recurrence of arrhythmic or non-arrhythmic syncopes. Methods and results: A total of 119 patients, who had received an implantable loop recorder for recurrent syncopes at our center between 01/2018 and 12/2021, participated in this retrospective cohort study. Anxiety, depression and quality of life were assessed using extensively validated questionnaires (GAD-7, PHQ-9 and SF-12). The mean follow-up after loop recorder implantation was 710 ± 430 days and 50% of patients were female. The mean patient age was 54.8 ± 18.6 years. Most patients had no evidence of structural heart disease (84%), and normal LV function (92%). A statistical analysis revealed that the presence of structural heart disease was the strongest predictor for arrhythmic syncope during follow-up. In patients with non-arrhythmic syncopes, we found significantly higher levels of anxiety (GAD-7 score: 2.5 ± 2.6 vs. 4.8 ± 4.3) and depression (PHQ-9 score: 3.9 ± 3.6 vs. 6.8 ± 5.1), and a lower quality of life (SF-12 score: 33.7 ± 6.4 vs. 29.6 ± 7.8). Discussion: We identified factors as contributors to a better identification of patients at risk for arrhythmic as well as non-arrhythmic syncopes. Especially anxious or depressive symptoms may hinted at non-arrhythmic causes of syncope. However, the study was limited by its retrospective design and low patient number. Further trials should likewise combine the diagnostic yield of loop recorders with psychometric evaluations before implantation and combine it with additional diagnostic measures, such as video monitoring, to further examine the role of psychological factors in the pathomechanism and treatment of syncope. |
| first_indexed | 2024-03-09T09:53:28Z |
| format | Article |
| id | doaj.art-04a50961f3a248e5a7858f1a3768d407 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T09:53:28Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-04a50961f3a248e5a7858f1a3768d4072023-12-01T23:52:37ZengMDPI AGJournal of Personalized Medicine2075-44262022-07-01128121910.3390/jpm12081219Psychological Aspects of Syncopes and Possible Association with Recurrency—The Role of Implantable Loop RecordersKevin Willy0Christian Ellermann1Sarah Syring2Benjamin Rath3Florian Reinke4Daniela Willy5Julian Wolfes6Felix K. Wegner7Lars Eckardt8Julia Köbe9Nexhmedin Morina10Department for Cardiology II: Electrophysiology, University Hospital Münster, Albert-Schweitzer-Campus 1 Gebäude A1, 48149 Münster, GermanyDepartment for Cardiology II: Electrophysiology, University Hospital Münster, Albert-Schweitzer-Campus 1 Gebäude A1, 48149 Münster, GermanyDepartment for Cardiology II: Electrophysiology, University Hospital Münster, Albert-Schweitzer-Campus 1 Gebäude A1, 48149 Münster, GermanyDepartment for Cardiology II: Electrophysiology, University Hospital Münster, Albert-Schweitzer-Campus 1 Gebäude A1, 48149 Münster, GermanyDepartment for Cardiology II: Electrophysiology, University Hospital Münster, Albert-Schweitzer-Campus 1 Gebäude A1, 48149 Münster, GermanyDepartment of Obstetrics and Gynecology, University Hospital Münster, 48419 Münster, GermanyDepartment for Cardiology II: Electrophysiology, University Hospital Münster, Albert-Schweitzer-Campus 1 Gebäude A1, 48149 Münster, GermanyDepartment for Cardiology II: Electrophysiology, University Hospital Münster, Albert-Schweitzer-Campus 1 Gebäude A1, 48149 Münster, GermanyDepartment for Cardiology II: Electrophysiology, University Hospital Münster, Albert-Schweitzer-Campus 1 Gebäude A1, 48149 Münster, GermanyDepartment for Cardiology II: Electrophysiology, University Hospital Münster, Albert-Schweitzer-Campus 1 Gebäude A1, 48149 Münster, GermanyDepartment of Psychology, University of Münster, 48419 Münster, GermanySyncopes are a very common phenomenon and have a high recurrence rate. The differentiation between the psychogenic and physical, especially of arrhythmic origin, remains difficult. In many cases, an implantable loop recorder is used for the detection of possible arrhythmias, leading to syncopes. Yet, the existing literature suggests that psychological factors may play a significant role in recurrent syncopes. We aimed at analyzing the potential role of several psychological factors on the recurrence of arrhythmic or non-arrhythmic syncopes. Methods and results: A total of 119 patients, who had received an implantable loop recorder for recurrent syncopes at our center between 01/2018 and 12/2021, participated in this retrospective cohort study. Anxiety, depression and quality of life were assessed using extensively validated questionnaires (GAD-7, PHQ-9 and SF-12). The mean follow-up after loop recorder implantation was 710 ± 430 days and 50% of patients were female. The mean patient age was 54.8 ± 18.6 years. Most patients had no evidence of structural heart disease (84%), and normal LV function (92%). A statistical analysis revealed that the presence of structural heart disease was the strongest predictor for arrhythmic syncope during follow-up. In patients with non-arrhythmic syncopes, we found significantly higher levels of anxiety (GAD-7 score: 2.5 ± 2.6 vs. 4.8 ± 4.3) and depression (PHQ-9 score: 3.9 ± 3.6 vs. 6.8 ± 5.1), and a lower quality of life (SF-12 score: 33.7 ± 6.4 vs. 29.6 ± 7.8). Discussion: We identified factors as contributors to a better identification of patients at risk for arrhythmic as well as non-arrhythmic syncopes. Especially anxious or depressive symptoms may hinted at non-arrhythmic causes of syncope. However, the study was limited by its retrospective design and low patient number. Further trials should likewise combine the diagnostic yield of loop recorders with psychometric evaluations before implantation and combine it with additional diagnostic measures, such as video monitoring, to further examine the role of psychological factors in the pathomechanism and treatment of syncope.https://www.mdpi.com/2075-4426/12/8/1219syncopearrhythmiamonitoringILRloop recordermental health |
| spellingShingle | Kevin Willy Christian Ellermann Sarah Syring Benjamin Rath Florian Reinke Daniela Willy Julian Wolfes Felix K. Wegner Lars Eckardt Julia Köbe Nexhmedin Morina Psychological Aspects of Syncopes and Possible Association with Recurrency—The Role of Implantable Loop Recorders Journal of Personalized Medicine syncope arrhythmia monitoring ILR loop recorder mental health |
| title | Psychological Aspects of Syncopes and Possible Association with Recurrency—The Role of Implantable Loop Recorders |
| title_full | Psychological Aspects of Syncopes and Possible Association with Recurrency—The Role of Implantable Loop Recorders |
| title_fullStr | Psychological Aspects of Syncopes and Possible Association with Recurrency—The Role of Implantable Loop Recorders |
| title_full_unstemmed | Psychological Aspects of Syncopes and Possible Association with Recurrency—The Role of Implantable Loop Recorders |
| title_short | Psychological Aspects of Syncopes and Possible Association with Recurrency—The Role of Implantable Loop Recorders |
| title_sort | psychological aspects of syncopes and possible association with recurrency the role of implantable loop recorders |
| topic | syncope arrhythmia monitoring ILR loop recorder mental health |
| url | https://www.mdpi.com/2075-4426/12/8/1219 |
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