OBJECTIVES: Unexplained Syncope is a major diagnostic challenge. Its differential diagnosis includes arrhythmias, epilepsy and psychological conditions. The Dutch FAST Study has showed that a significant percentage of syncope patients will be left undiagnosed (and therefore untreated) after full evaluation. These patients will constantly faint until a diagnosis is established and proper treatment is administered. However, a diagnosis cannot be established unless syncope recurs. Implantable Loop Recorders (ILRs) significantly increase the probability of obtaining a diagnosis after that happens, possibly allowing patients to receive treatment faster and thus stop further syncope attacks. With every syncope attack being associated with injuries and additional diagnostic tests, the cost implications of preventing them can be significant. We sought to examine potential cost-savings associated with preventing syncope attacks by ILR use under the Dutch setting. METHODS: Markov Model in Excel used to conduct Cost-Minimisation Analysis from the Dutch Healthcare System perspective. Literature reviews used for blackout recurrence, yield of conventional diagnostics, yield of ILRs, arrhythmia prevalence and injury risk. Dutch costing were obtained for diagnostic tests and injury treatment. All costs discounted at 4% p.a. RESULTS: ILRs proved very cost-saving. Base case diagnosis and treatment costs per patient was reduced by 81.9% (€20,622 without ILR vs. €11,336 with ILR), or €5,454 saved per ILR implanted. CONCLUSIONS: ILRs can be significantly cost-saving and the potential cost-savings to the healthcare system far exceed the price of the device. Further research is needed to introduce the outcomes component and account for HRQoL benefits of avoiding debilitating injuries and improving patient survival. We expect that the additional research can only strengthen the case in favour of wider adoption of ILR use.