{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T19:09:05Z","timestamp":1788721745038,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T00:00:00Z","timestamp":1788652800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T00:00:00Z","timestamp":1788652800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The optimal duration of implantable loop recorder (ILR) monitoring remains uncertain and may differ according to the indication for implantation. We evaluated whether the time\u2010dependent diagnostic yield and clinical relevance of ILR\u2010detected arrhythmias differ among patients implanted for syncope, palpitations, cryptogenic stroke, or Brugada syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study sought to define the time\u2010dependent diagnostic yield of ILRs across clinical indications and to assess whether early and late diagnoses differed in their impact on clinical management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>We retrospectively analyzed 1734 consecutive patients undergoing ILR implantation at 5 Italian centers for unexplained syncope, palpitations, cryptogenic stroke, or Brugada syndrome. Diagnosis of interest was defined according to the implant indication: pauses for syncope, supraventricular tachycardia or atrial fibrillation for palpitations, atrial fibrillation for cryptogenic stroke, and ventricular tachycardia or pauses for Brugada syndrome. Median follow\u2010up was 34 months. Maximally selected rank statistics identified 26 months as the global threshold separating early from late diagnoses, while indication\u2010specific optimal diagnostic windows were 14 months for syncope, 13 months for palpitations, 16 months for cryptogenic stroke, and 55 months for Brugada syndrome. In syncope and palpitations, most actionable diagnoses occurred early, and diagnostic efficiency declined markedly after 26 months, with late findings often less clearly related to the index presentation. In cryptogenic stroke, atrial fibrillation detection was most frequent early but could still lead to changes in antithrombotic management later, supporting an individualized \u201cgray\u2010zone\u201d approach to prolonged monitoring. By contrast, Brugada syndrome showed sustained diagnostic yield over extended follow\u2010up, with late ventricular arrhythmias or pauses retaining major prognostic and therapeutic implications, including implantable cardioverter\u2010defibrillator implantation and device\u2010type selection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The value of ILR monitoring is strongly time\u2010 and indication\u2010dependent. Prolonged routine monitoring or reimplantation appears to have limited incremental value in syncope and palpitations when early follow\u2010up is unrevealing, whereas extended surveillance may remain justified in Brugada syndrome and should be individualized after cryptogenic stroke. These observations support indication\u2010driven ILR follow\u2010up strategies rather than a uniform approach based on device longevity alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70469","type":"journal-article","created":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T18:30:26Z","timestamp":1788719426000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Time\u2010Dependent Diagnostic Yield and Therapeutic Impact of Implantable Loop Recorders, Brugada Syndrome as the Exception"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6604-1756","authenticated-orcid":false,"given":"Luigi","family":"Cocchiara","sequence":"first","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Division of Cardiology Federico II University of Naples Naples Italy"},{"name":"Cardiology, Heart Department Pineta Grande Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Brescia","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Division of Cardiology Federico II University of Naples Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2677-9214","authenticated-orcid":false,"given":"Procolo","family":"Marchese","sequence":"additional","affiliation":[{"name":"EP Lab Cardiology Mazzoni Hospital, AST Ascoli Piceno Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Nardi","sequence":"additional","affiliation":[{"name":"Cardiology, Heart Department Pineta Grande Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Argenziano","sequence":"additional","affiliation":[{"name":"Cardiology, Heart Department Pineta Grande Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianmarco","family":"Arabia","sequence":"additional","affiliation":[{"name":"Division of Cardiology Spedali Civili Hospital Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9122-9534","authenticated-orcid":false,"given":"Marco","family":"Micillo","sequence":"additional","affiliation":[{"name":"U.O. Sincope Unit IRCCS Neuromed Pozzilli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Gennaro","sequence":"additional","affiliation":[{"name":"Cardiology, Heart Department Pineta Grande Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Mazzotta","sequence":"additional","affiliation":[{"name":"Cardiology, Heart Department Pineta Grande Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4616-9300","authenticated-orcid":false,"given":"Lucio","family":"Addeo","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Division of Cardiology Federico II University of Naples Naples Italy"},{"name":"Betania Evangelical Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Landolfi","sequence":"additional","affiliation":[{"name":"U.O. Sincope Unit IRCCS Neuromed Pozzilli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emiliano","family":"Calvi","sequence":"additional","affiliation":[{"name":"Division of Cardiology Spedali Civili Hospital Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8081-0577","authenticated-orcid":false,"given":"Manuel","family":"Cerini","sequence":"additional","affiliation":[{"name":"Division of Cardiology Spedali Civili Hospital Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Nicolai","sequence":"additional","affiliation":[{"name":"Division of Cardiology Spedali Civili Hospital Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Strisciuglio","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Division of Cardiology Federico II University of Naples Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Vergara","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Division of Cardiology Federico II University of Naples Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0565-7127","authenticated-orcid":false,"given":"Giovanni","family":"Esposito","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Division of Cardiology Federico II University of Naples Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Rapacciuolo","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Division of Cardiology Federico II University of Naples Naples Italy"},{"name":"Betania Evangelical Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,6]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehp298"},{"issue":"3","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/S0735-1097(03)00659-4","article-title":"Cost Implications of Testing Strategy in Patients With Syncope","volume":"42","author":"Krahn A. 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