# An Implantable Loop Recorder in the Diagnosis of Cardiac Arrhythmias: The Importance of Drug Treatment in Predicting Pacemaker Requirement

## TL;DR

This study shows that implantable loop recorders are effective in diagnosing heart rhythm issues that may require a pacemaker, especially in patients taking anticoagulants or diuretics.

## Contribution

The study identifies drug treatments as significant predictors of pacemaker requirement when using implantable loop recorders.

## Key findings

- Oral anticoagulants and diuretics significantly predict pacemaker-requiring arrhythmias detected by ILRs.
- Implantable loop recorders are effective in diagnosing cardiac arrhythmias needing permanent pacemaker implantation.
- Prolonged pauses in cardiac activity were the most common reason for pacemaker implantation.

## Abstract

Background: An implantable loop recorder (ILR) represents the gold standard in the diagnosis of cardiac arrhythmias in patients with neurological or cardiac symptoms. Our study aimed to determine the real-world diagnostic effectiveness of ILRs in detecting arrhythmias requiring permanent pacemaker implantation. Methods: The study enrolled and followed up for two years 62 ILR recipients from the Cardiology Clinic of the Clinical Center Kragujevac, Serbia. Results: The most common indication for pacemaker implantation was pauses in cardiac activity (83%). The use of oral anticoagulants (OR: 11.80; 95% CI: 1.76, 79.4), ACE inhibitors or AT receptor blockers (OR: 3.87; 95% CI: 1.21, 12.35), and diuretics (OR: 5.29; 95% CI: 1.55, 18.04) had a statistically significant impact on the detection of pacemaker-requiring arrhythmias by an ILR. After adjustment for other factors of influence, oral anticoagulants (OR: 7.82; 95% CI: 1.08, 56.9) and diuretics (OR: 3.68; 95% CI: 1.04, 13.00) remained significant in predicting pacemaker requirement in ILR recipients. Conclusions: An ILR represents an effective diagnostic approach in detecting cardiac arrhythmias requiring permanent pacemaker implantation, especially in patients treated with oral anticoagulants or diuretics.