The implantable loop recorder in high-risk syncope

: Syncope is a common presentation, with the main challenge being identification of higher-risk patients. Often, treatment decisions are complex and require close monitoring prior to making a definitive management plan. This is particularly the case in those presenting with ventricular arrhythmia (VA). We describe a case of a 64-year-old male who presents with presyncope and probable VA. The patient subsequently had an implantable loop recorder (ILR) placed, which guided the final decision to insert an implantable cardioverter defibrillator. This case illustrates the general approach to patients presenting with syncope and VA and the use of newer technology, such as the ILR, in guiding definitive management strategies.