Immediate Ambulatory Electrocardiographic Monitoring in Syncope.

In UK adults with syncope unexplained after emergency-department evaluation, 14-day ambulatory ECG monitoring did not significantly reduce 1-year patient-reported syncope episodes (IRR 0.89; P=0.42).

• Why it matters: Diagnosing a cardiac arrhythmia in emergency-department syncope remains difficult, and it is unclear whether short-term ambulatory ECG monitoring improves outcomes beyond standard care.
• What they did: In an open-label randomized trial at 45 UK hospitals, 2234 adults were assigned to 14-day ambulatory ECG monitoring or site-specific standard care, with primary analysis after follow-up completion.
• The result: At 1 year, mean syncope episodes were 1.37±5.10 vs 1.58±8.56, and monitoring showed no significant difference, implying limited added benefit for this population.