Predictors of pacemaker requirement in patients with implantable loop recorder and unexplained syncope: A systematic review and meta‐analysis

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Identifying the underlying cause of unexplained syncope is crucial for appropriate management of recurrent syncopal episodes. Implantable loop recorders (ILRs) have emerged as valuable diagnostic tools for monitoring patients with unexplained syncope. However, the predictors of pacemaker requirement in patients with ILR and unexplained syncope remain unclear. In this study, we shed light on these prognostic factors. PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane CENTRAL were systematically searched until May 04, 2023. Studies that evaluated the predictors of pacemaker requirement in patients with implantable loop recorder and unexplained syncope were included. The “Quality In Prognosis Studies” appraisal tool was used for quality assessment. The pooled odds ratio (OR) with 95% confidence intervals (CIs) was calculated. The publication bias was evaluated using Egger's and Begg's tests. Ten studies ( n = 4200) were included. Right bundle branch block (OR: 3.264; 95% CI: 1.907–5.588, p < .0001) and bifascicular block (OR: 2.969; 95% CI: 1.859–4.742, p < .0001) were the strongest predictors for pacemaker implantation. Pacemaker requirement was more than two times in patients with atrial fibrillation, sinus bradycardia and first degree AV block. Valvular heart disease, diabetes mellitus, and hypertension were also significantly more in patients with pacemaker implantation. Age (standardized mean difference [SMD]: 0.560; 95% CI: 0.410/0.710, p < .0001) and PR interval (SMD: 0.351; 95% CI: 0.150/0.553, p = .001) were significantly higher in patients with pacemaker requirement. Heart conduction disorders, atrial arrhythmias and underlying medical conditions are main predictors of pacemaker device implantation following loop recorder installation in unexplained syncopal patients.

Abstract

Heart conduction disorders, atrial arrhythmias and underlying medical conditions are main predictors of pacemaker device implantation following loop recorder installation in unexplained syncopal patients.

Related collections

Most cited references 50

Record: found
Abstract: found
Article: not found

Quantifying heterogeneity in a meta-analysis.

Julian P T Higgins, Simon G Thompson (2002)

The extent of heterogeneity in a meta-analysis partly determines the difficulty in drawing overall conclusions. This extent may be measured by estimating a between-study variance, but interpretation is then specific to a particular treatment effect metric. A test for the existence of heterogeneity exists, but depends on the number of studies in the meta-analysis. We develop measures of the impact of heterogeneity on a meta-analysis, from mathematical criteria, that are independent of the number of studies and the treatment effect metric. We derive and propose three suitable statistics: H is the square root of the chi2 heterogeneity statistic divided by its degrees of freedom; R is the ratio of the standard error of the underlying mean from a random effects meta-analysis to the standard error of a fixed effect meta-analytic estimate, and I2 is a transformation of (H) that describes the proportion of total variation in study estimates that is due to heterogeneity. We discuss interpretation, interval estimates and other properties of these measures and examine them in five example data sets showing different amounts of heterogeneity. We conclude that H and I2, which can usually be calculated for published meta-analyses, are particularly useful summaries of the impact of heterogeneity. One or both should be presented in published meta-analyses in preference to the test for heterogeneity. Copyright 2002 John Wiley & Sons, Ltd.

0 comments Cited 5672 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range

Xiang Wan, Wenqian Wang, Jiming Liu … (2014)

Background In systematic reviews and meta-analysis, researchers often pool the results of the sample mean and standard deviation from a set of similar clinical trials. A number of the trials, however, reported the study using the median, the minimum and maximum values, and/or the first and third quartiles. Hence, in order to combine results, one may have to estimate the sample mean and standard deviation for such trials. Methods In this paper, we propose to improve the existing literature in several directions. First, we show that the sample standard deviation estimation in Hozo et al.’s method (BMC Med Res Methodol 5:13, 2005) has some serious limitations and is always less satisfactory in practice. Inspired by this, we propose a new estimation method by incorporating the sample size. Second, we systematically study the sample mean and standard deviation estimation problem under several other interesting settings where the interquartile range is also available for the trials. Results We demonstrate the performance of the proposed methods through simulation studies for the three frequently encountered scenarios, respectively. For the first two scenarios, our method greatly improves existing methods and provides a nearly unbiased estimate of the true sample standard deviation for normal data and a slightly biased estimate for skewed data. For the third scenario, our method still performs very well for both normal data and skewed data. Furthermore, we compare the estimators of the sample mean and standard deviation under all three scenarios and present some suggestions on which scenario is preferred in real-world applications. Conclusions In this paper, we discuss different approximation methods in the estimation of the sample mean and standard deviation and propose some new estimation methods to improve the existing literature. We conclude our work with a summary table (an Excel spread sheet including all formulas) that serves as a comprehensive guidance for performing meta-analysis in different situations. Electronic supplementary material The online version of this article (doi:10.1186/1471-2288-14-135) contains supplementary material, which is available to authorized users.

0 comments Cited 2415 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: not found
Article: not found

Operating Characteristics of a Rank Correlation Test for Publication Bias

Colin Begg, Madhuchhanda Mazumdar (1994)

0 comments Cited 1920 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Mohammad Sharifian Ardestani:

ORCID: http://orcid.org/0009-0008-1328-503X

msharifian26@gmail.com

Azadeh Aletaha: azadeh.aletaha@gmail.com

Journal

Journal ID (nlm-ta): Clin Cardiol

Journal ID (iso-abbrev): Clin Cardiol

Journal ID (doi): 10.1002/(ISSN)1932-8737

Journal ID (publisher-id): CLC

Title: Clinical Cardiology

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Print): 0160-9289

ISSN (Electronic): 1932-8737

Publication date (Electronic): 29 January 2024

Publication date Collection: February 2024

Volume: 47

Issue: 2 ( doiID: 10.1002/clc.v47.2 )

Electronic Location Identifier: e24221

Affiliations

[ ¹ ] Endocrinology and Metabolism Re‐search Center, Institute of Basic and Clinical Physiology Sciences Kerman University of Medical Sciences Kerman Iran

[ ² ] Shahid Beheshti University of Medical Sciences School of Medicine Tehran Iran

[ ³ ] Cardiovascular Research Center Shahid Beheshti University of Medical Sciences Tehran Iran

[ ⁴ ] Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute Tehran University of medical Sciences Tehran Iran

[ ⁵ ] Endocrinology and Metabolism Clinical Sciences Institute, Endocrinology and Metabolism Research Center Tehran University of Medical Sciences Tehran Iran

Author notes

[*] [* ] Correspondence Mohammad Sharifian Ardestani, MD, Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Email: msharifian26@ 123456gmail.com

Azadeh Aletaha, PhD, Evidence‐Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Email: azadeh.aletaha@ 123456gmail.com

Author information

Moein Zangiabadian http://orcid.org/0000-0002-7454-7944

Shayan Bastami http://orcid.org/0000-0002-2288-0550

Mohammad Ali Akbarzadeh http://orcid.org/0000-0001-7790-5439

Mohammad Sharifian Ardestani http://orcid.org/0009-0008-1328-503X

Article

Publisher ID: CLC24221

DOI: 10.1002/clc.24221

PMC ID: 10823547

SO-VID: 5201f6a2-e505-4c39-abdf-ad936eb5cdfc

License:

This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

History

Date revision received : 08 January 2024

Date received : 23 September 2023

Date accepted : 10 January 2024

Page count

Figures: 3, Tables: 3, Pages: 10, Words: 5180

Custom metadata

source-schema-version-number 2.0

cover-date February 2024

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.6 mode:remove_FC converted:29.01.2024

ScienceOpen disciplines: Cardiovascular Medicine

Keywords: ilr,implantable loop recorder,pacemaker,predictor,unexplained syncope

Data availability:

ScienceOpen disciplines: Cardiovascular Medicine

Keywords: ilr, implantable loop recorder, pacemaker, predictor, unexplained syncope

Predictors of pacemaker requirement in patients with implantable loop recorder and unexplained syncope: A systematic review and meta‐analysis

Read this article at

Abstract

Abstract

Related collections

Karger: Cardiovascular System

Most cited references 50

Quantifying heterogeneity in a meta-analysis.

Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range

Operating Characteristics of a Rank Correlation Test for Publication Bias

Author and article information

Contributors

Journal

Affiliations

Author notes

Author information

Article

History

Page count

Categories

Custom metadata

Comments

Comment on this article

Similar content 352

Most referenced authors 1,732