Revealing: Data retrieved from an implantable loop recorder

This patient is an 80-year-old man with a history of recurrent syncope of unknown etiology who underwent an extensive cardiac and neurologic evaluation which was essentially negative. The patient subsequently received an implantable loop recorder (Reveal(TM), Medtronic, Inc., Minneapolis, Minnesota), Eight months after implantation, this device was activated by the patient following a syncopal episode. The episode revealed over 30 seconds of sinus arrest with only 3 ventricular escape complexes observed during that time. The patient activated this device and was subsequently referred for a dual chamber permanent pacemaker, which was implanted without complications. This case illustrates the advantages of a non-vascular, implantable loop recorder for helping to define the etiology of recurrent unexplained syncope.