Does familiarity with technology predict successful use of an external loop recorder? The loop recorder technology cognition study (LOCO).

BACKGROUND

The diagnosis of presyncope, syncope, and palpitations is facilitated by successful documentation of the cardiac rhythm during symptoms. We prospectively assessed technological familiarity using a Technology Cognition Questionnaire to determine influence on proper and effective use of an external loop recorder (ELR).

METHODS

Patients with palpitations, presyncope, or syncope were assessed for familiarity with technology and provided an ELR for a period of 6 weeks. Proper use of the device was demonstrated to the patient and test transmissions were sent by analog telephone line on a weekly basis. Patients were instructed to activate the device to record cardiac rhythm when symptoms recurred, and to send these recordings via telephone transmission.

RESULTS

Ninety-two patients were prospectively enrolled, with mean age 54.9 +/- 20.9 and 42 males (46%). Sixty-five patients (71%) had recurrence of symptoms during the 6-week monitoring period. Among these patients, 40 (62%) were successful in recording and transmitting data such that a diagnosis was made at a median of 8 days (IQR 12.5, range 0-30). Among patients with symptoms during the monitoring period, 36 (55%) had at least one failed recording or transmission. On multivariate analysis, failed symptom recording/transmission was less likely among patients able to program a home video recorder (odds ratio [OR] 0.25 [0.07-0.93]), and more likely among patients who failed a test transmission (OR 3.45 [1.04-11.7]). No variables were independently associated with successful diagnosis.

CONCLUSIONS

Familiarity with technology correlates with successful use of the ELR, but does not necessarily correlate with the ability to reach a diagnosis.