This trial is active, not recruiting.

Condition palpitations
Treatment implantable loop recorder
Sponsor Barts & The London NHS Trust
Start date April 2010
End date August 2015
Trial size 56 participants
Trial identifier NCT01170559, 006628 BLT


Heart rhythm abnormalities underlie one of the common presenting complaints to the A&E and out-patient departments, specifically awareness of heart beats or palpitations. Unless an ECG (electrocardiogram) tracing of the heart rhythm can be recorded while the patient is having symptoms, it is very difficult to determine the cause of the palpitations. The conventional approach is to refer these patients from the emergency departments to the Cardiology outpatients where they undergo repeated short term rhythm monitoring hoping to record the rhythm underlying the patient's complaint. Unfortunately, this often yields no results thus delaying definitive treatment and incurring extra costs of repeated investigations and A&E presentations. This study aims to compare the ability of the conventional approach to establish a definite diagnosis compared to that of an early invasive monitoring approach with a small implantable device that records the heart rhythm at all time for up to 18 months.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Allocation randomized
Intervention model parallel assignment
Masking open label
Primary purpose diagnostic
Group allocated to receiving an ILR in the A&E department.
implantable loop recorder Reveal XT
(No Intervention)
Group randomised to conventional lines of investigation

Primary Outcomes

The primary endpoint of the study is the proportion of patients achieving a definite diagnosis in each of the two groups at the end of one year
time frame: 1 year

Secondary Outcomes

The time taken from randomisation in the A&E to making the diagnosis (if any) in each group
time frame: 1 Year
The cost of achieving a diagnosis in each group
time frame: 1 Year

Eligibility Criteria

Male or female participants at least 18 years old.

Inclusion Criteria: - Age 18 years or older - Good history of episodic symptomatic sustained palpitations (sudden onset and offset, fast heart beats, may be associated with shortness of breath or dizziness) - Terminates before presentation to hospital - Episodes occur at a frequency of less than once every two weeks - Never previously caught on ECG or ambulatory monitoring - Normal resting ECG Exclusion Criteria: - Contraindication to ILR implantation i.e. ongoing oral anticoagulation with INR >1.6, ongoing infection, sepsis or fever, etc. - Palpitations suggestive of extrasystoles (single missed or dropped beats) - Known or suspected severe valvular or myocardial heart disease - An audible heart murmur - Any abnormality on the surface ECG - Thyrotoxicosis - Patients who refuse an ILR when offered will not be included in either limb of the study

Additional Information

Official title Use of Implantable Loop Recorders as a Primary Investigation of Infrequent Undiagnosed ArrhythmIa Symptoms in the Emergency Department
Principal investigator Richard Schilling, MD, FRCP
Trial information was received from ClinicalTrials.gov and was last updated in August 2014.
Information provided to ClinicalTrials.gov by Barts & The London NHS Trust.