Figure 9 Number of syncopes (A) and duration of symptoms (B) in 346 patients (53% male, mean age 56 (20) years), believed to have syncope undergoing long term ECG monitoring with an implanted loop recorder (ILR). In the ILR group 251 (72.6%) of patients achieved SECGC during typical symptoms. Time to first recording was 68 (79) days (range 1–276 days). Forty eight (14%) patients had severe bradycardia or asystole and received permanent pacemakers; five (1.5%) patients had tachyarrhythmias and the findings guided further investigations; and 104 (30%) patients had milder bradycardia and were believed to have reflex syncope. The remainder (55%) had no arrhythmias recorded during typical symptoms, and the diagnosis remains obscure.