P5669Clinical management of syncope patients guided by insertable cardiac monitors in Europe
Bibliographic record
Abstract
Abstract Introduction Current European guidelines recommend the use of insertable cardiac monitors (ICMs) in the early phase of evaluation for patients with recurrent, unexplained syncope and a likelihood of recurrence during the device battery life. The ongoing Reveal LINQ Registry collects real-world data on clinical actions guided by the insertable cardiac monitor (ICM) in these patients. Purpose To characterize ICM-guided diagnosis and treatment of syncope patients in Europe. Methods The Reveal LINQ Registry is a prospective, observational, multi-center study evaluating real-world performance of the ICM. Patients from European centres who had syncope indicated as the reason for ICM implant were included in the analysis. Kaplan-Meier methods were used to determine the percentage of patients receiving treatment. Results In total, 139 patients from 12 centres [Portugal (78); The Netherlands (30); Belgium (12); Italy (10); Germany (5); United Kingdom (4)] received an ICM to monitor for unexplained syncope and had at least one follow-up visit. The mean age was 61.2 and 51.1% were female. During a mean follow-up time of 11.2 months, 31 patients experienced at least one recurrent syncope event classified as: cardiac (9), vasovagal (4), idiopathic (8) and unknown (10). An arrhythmia was diagnosed in 14 (45.2%) patients with a recurrent event and clinical actions were taken in 12 (38.7%) patients (10 IPGs, and 2 AF ablations). Among patients without a recurrence, 25 (23.1%) had an arrhythmia diagnosed and 20 (18.5%) had a clinical action taken (13 therapeutic device implants, 4 ablations, and 3 medication changes). Overall, the rate of clinical actions was 32.6% after 18 months of ICM follow-up in the unexplained syncope population (Figure). Time to treatment Conclusion Clinical actions are taken in approximately one third of unexplained syncope patients monitored with an ICM after 18 months of follow up. Acknowledgement/Funding Medtronic
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".