{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:45:33Z","timestamp":1790811933771,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T00:00:00Z","timestamp":1706486400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    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 \u201cQuality In Prognosis Studies\u201d 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                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20094200) were included. Right bundle branch block (OR: 3.264; 95% CI: 1.907\u20135.588,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.0001) and bifascicular block (OR: 2.969; 95% CI: 1.859\u20134.742,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.0001) 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,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.0001) and PR interval (SMD: 0.351; 95% CI: 0.150\/0.553,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.001) 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.\n                  <\/jats:p>","DOI":"10.1002\/clc.24221","type":"journal-article","created":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T06:48:25Z","timestamp":1706510905000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Predictors of pacemaker requirement in patients with implantable loop recorder and unexplained syncope: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7454-7944","authenticated-orcid":false,"given":"Moein","family":"Zangiabadian","sequence":"first","affiliation":[{"name":"Endocrinology and Metabolism Re\u2010search Center, Institute of Basic and Clinical Physiology Sciences Kerman University of Medical Sciences Kerman Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiarash","family":"Soltani","sequence":"additional","affiliation":[{"name":"Shahid Beheshti University of Medical Sciences School of Medicine Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasaman","family":"Gholinejad","sequence":"additional","affiliation":[{"name":"Shahid Beheshti University of Medical Sciences School of Medicine Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reyhane","family":"Yahya","sequence":"additional","affiliation":[{"name":"Shahid Beheshti University of Medical Sciences School of Medicine Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2288-0550","authenticated-orcid":false,"given":"Shayan","family":"Bastami","sequence":"additional","affiliation":[{"name":"Shahid Beheshti University of Medical Sciences School of Medicine Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7790-5439","authenticated-orcid":false,"given":"Mohammad Ali","family":"Akbarzadeh","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1328-503X","authenticated-orcid":false,"given":"Mohammad","family":"Sharifian Ardestani","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azadeh","family":"Aletaha","sequence":"additional","affiliation":[{"name":"Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute Tehran University of medical Sciences Tehran Iran"},{"name":"Endocrinology and Metabolism Clinical Sciences Institute, Endocrinology and Metabolism Research Center Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,29]]},"reference":[{"issue":"5","key":"e_1_2_10_2_1","first-page":"303","article-title":"Syncope: evaluation and differential diagnosis","volume":"95","author":"Runser LA","year":"2017","journal-title":"Am Fam Physician"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012407"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","unstructured":"Cheshire Jr.WPSyncope. 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