{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:41:58Z","timestamp":1777858918175,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>Introduction: External loop recorders (ELRs) are recommended for the investigation of syncope and palpitations. This study aimed to compare rates of arrhythmia detection between primary care (PC) and hospital-based cardiac unit (HBCU) fitted ELRs. Methods: Data were captured from January to December 2015. Twenty-eight general practitioner practices and 1 hospital took part. Patients were divided into those with ELR fitted in PC or HBCU. All ELR data were analyzed by a cardiac physiologist. Results: A total of 560 ELR recordings were analyzed; 219 (PC) versus 341 (HBCU). There was no difference between the baseline characteristics (all Ps &gt; .05). The predominant indication for ELR in each group were palpitations; between-group variation was observed for syncope ( P = .0004). There were no significant between-group differences in the number of recordings per patient; however, PC group wore the ELR for less time (median 7 days vs median 14 days; P &lt; .0001). There were no differences in arrhythmia detection between PC- and HBCU-fitted ELRs (16.2% [n = 39] vs 21.7% [n = 74], respectively; P = .28). PC placement of ELRs was highest in very remote rural communities ( P = .005) and correlated with distance from HBCU ( r = 0.39; P = .04). Conclusions: This study showed no difference in detection of arrhythmias between PC and HBCU fitted ELRs. This suggests adequate ELR recording can be completed by suitably trained staff in PC. Furthermore, ELRs were fitted for less time in PC without an adverse effect on diagnostic yield. ELR usage increased with increasing distance from the specialist center and rurality suggesting improved local access to arrhythmia detection services.<\/jats:p>","DOI":"10.1177\/2150132720946147","type":"journal-article","created":{"date-parts":[[2020,7,29]],"date-time":"2020-07-29T06:35:24Z","timestamp":1596004524000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["External Loop Recorders: Primary Care Placement Is Noninferior to Hospital-Based Cardiac Unit"],"prefix":"10.1177","volume":"11","author":[{"given":"Kara J.","family":"Callum","sequence":"first","affiliation":[{"name":"NHS Highland, Raigmore Hospital, Inverness, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynn","family":"Hall","sequence":"additional","affiliation":[{"name":"NHS Highland, Raigmore Hospital, Inverness, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Jack","sequence":"additional","affiliation":[{"name":"NHS Highland, Raigmore Hospital, Inverness, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin","family":"Farman","sequence":"additional","affiliation":[{"name":"NHS Highland, Raigmore Hospital, Inverness, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gordon F.","family":"Rushworth","sequence":"additional","affiliation":[{"name":"University of the Highlands and Islands, Centre for Health Science, Inverness, UK"},{"name":"Highland Pharmacy Education & Research Centre, Centre for Health Science, Inverness, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1403-4733","authenticated-orcid":false,"given":"Stephen J.","family":"Leslie","sequence":"additional","affiliation":[{"name":"NHS Highland, Raigmore Hospital, Inverness, UK"},{"name":"University of the Highlands and Islands, Centre for Health Science, Inverness, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,7,29]]},"reference":[{"key":"bibr1-2150132720946147","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehp298"},{"key":"bibr2-2150132720946147","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eup097"},{"key":"bibr3-2150132720946147","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eur130"},{"key":"bibr4-2150132720946147","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euu222"},{"key":"bibr5-2150132720946147","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eus264"},{"key":"bibr6-2150132720946147","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2010.193417"},{"key":"bibr7-2150132720946147","unstructured":"Remote and Rural Steering Group. Delivering for remote and rural healthcare. The final report of the remote and rural workstream. Accessed July 15, 2020. https:\/\/www.ficm.ac.uk\/sites\/default\/files\/scotland_remote_and_rural.pdf"},{"key":"bibr8-2150132720946147","unstructured":"Scottish Government. Better health, better care: action plan. Accessed July 15, 2020. https:\/\/www.gov.scot\/publications\/better-health-better-care-action-plan\/#:~:text=This%20Action%20Plan%20sets%20out,faster%20access%20to%20health%20care."},{"key":"bibr9-2150132720946147","volume-title":"The Scottish Healthcare Science National Delivery Plan 2015-2020","author":"Scottish Government","year":"2015"},{"key":"bibr10-2150132720946147","unstructured":"Scotland\u2019s Census 2011. Accessed December 7, 2013. https:\/\/www.scotlandscensus.gov.uk"},{"key":"bibr11-2150132720946147","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2010.07.005"},{"key":"bibr12-2150132720946147","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2014.03.005"},{"key":"bibr13-2150132720946147","doi-asserted-by":"publisher","DOI":"10.22605\/RRH1142"},{"key":"bibr14-2150132720946147","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2015.01.005"},{"key":"bibr15-2150132720946147","doi-asserted-by":"publisher","DOI":"10.1016\/j.sapharm.2017.01.002"},{"key":"bibr16-2150132720946147","volume-title":"Scottish Government Urban\/Rural Classification 2009\/2010","author":"Scottish Government","year":"2010"},{"key":"bibr17-2150132720946147","unstructured":"National Institute for Health and Care Excellence. Transient loss of consciousness (\u2018blackouts\u2019) in over 16s. 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