Currently available ICMs can provide long-term ECG monitoring for approximately 3 years, and its clinical usefulness to confirm the diagnosis in patients with syncope of unknown cause has been well established, ,. The use of an insertable cardiac monitor (ICM) is now strongly recommended by published practice guidelines for detecting infrequently, but clinically important symptoms.

once or twice a month or a few times per year). Longer-term monitoring is often essential to document symptoms that occur infrequently (e.g. Several ambulatory ECG (AECG) monitoring technologies are currently available, but the majority of them can be used only for a few days to several weeks. ECG is of special value when a definite cause cannot be obtained by history and clinical examinations. The gold standard to elucidate the etiologic diagnosis of spontaneous symptoms particularly during spontaneous transient loss of consciousness (T-LOC) is the electrocardiogram (ECG) registered during these episode. Specifically, we focus on the use of ELR and ICM for evaluating Japanese patients with T-LOC. In this report, based on our clinical experience, we review the usefulness of ambulatory ECG monitoring devices, especially of ELR, for evaluating T-LOC and other potentially arrhythmia-related symptoms. Frequent events may be adequately detected by Holter ECG, but less frequent symptoms are more effectively assessed by longer-term monitoring (i.e., ELR or ICM). However, the appropriate monitor choice should be based on the expected frequency of symptoms. Of them, Holter ECG is most frequently used in daily practice in Japan, while ELR and ICM are less frequently used. Current ambulatory ECG monitoring technologies include 24-hour Holter, wearable event recorder, external loop recorder (ELR), and insertable cardiac monitoring (ICM). Capturing electrocardiograms (ECGs) during spontaneous events is the most powerful available tool to identify or exclude an arrhythmic cause of symptoms, and often can elucidate the definite diagnosis for different conditions, such as transient loss of consciousness (T-LOC), lightheadedness, or palpitations.

Loop memory monitor