In so many words, let him do as he likes. Honestly, all that work is unnecessary. Having invasive work for one episode--not even a bad episode, as the collapse has several other causes and the syncope didn't last after recovery--can seriously screw up his life. Your doctors are either paranoid since he is a runner (in the off chance that something is wrong with his heart, running is pretty much the worst thing to be doing), or they're trying to make some money by offering a non-vital procedure--that does happen, unfortunately.
Long story short, though, people often get freaked out by arrhythmias. Most of the time they aren't anything besides uncomfortable. The only reason you should be worried is if he has long QT syndrome or an extra electrical pathway within the heart--both of which would have been discovered already, unless you've got some incompetent doctors. Arrhythmias that don't come from these conditions are, for the most part, caused by a disturbance of the heart (i.e. large amount of cardiac stimulant in the blood, in rare cases sharp inhalation during a very specific period within the cardiac cycle, heavy blow to the chest). Exhaustion is just one of the many things that can cause an irregular beat. I'd figure that he doesn't want the procedure because he hears the term 'invasive,' and regardless of what level of disturbance this would put in his life, just the psychological aspect would likely make it difficult. Really, though, if his heart is going to stop beating from an arrhythmia, considering the history you've told us, the implanted device would just be a waste.
I'll add, too, that the implantable defibrillators are bad for the under fifty and active crowd. It would put an end to his running (it triggers at a certain heart rate), there have been several cases of malfunctioning pieces causing heart attacks, and it requires surgery every couple of years. In the end, then, there's a decent chance that getting overly concerned about this one episode could wreck his life as he lives it. Your son will be fine, just let him be and remember that he's still if not less, likely to keel over dead than any other active twenty year old.
at some point i would hope that your son sees that in his case he is lucky that a potential fatal event did not happen while he was running and would do everything to make sure that it doesn't. at the age of 20 he has many years of running in his future, and i would think that he doesn't want to have this in the back of his mind every time he's at the starting line of a marathon. i am sure that every experienced runner would tell him to have this done, from what i understand they are very disciplined and take great care to take care of their bodies (and minds) having this test, while it may be an irritant for a short period, will give him peace of mind to be able to continue with his love of running for many years to come. as the parent of daughter near your son's age with a heart condition i feel for you. i spent two years waking up every day worrying about her heart, now she is doing better than she has in three years, and while it is still an issue we can plan for her future without having that fear hanging like a cloud. please let us know how everything goes and of course we wish your family good health and peace of mind
dawn
An internal loop monitor is barely invasive and won't affect his daily life. While it is possible that the strain of the marathon (remember that the first guy to run 26 miles died within an hour of completing his task) is the sole trigger for his episode, his continued interest in competitive running is a significant risk given his serious reaction. He can continue to run, date, drink (if he does), sleep, eat etc. as usual, but he'll have that nifty little bionic device recording his heart's reaction to it all so that the doctors can be sure that he doesn't have an underlying and possibly deadly arrhythmia.
What's the big deal? Big payoff if you find something, no loss if you don't.
Consider, however, that your husband and son may be reacting with such adamant distaste for the test because of FEAR of what it MAY reveal. Many people faced with possible bad news much prefer denial over action. Your husband may be very frightened of what the loop could uncover, and your son, both influenced by his father AND frightened of what he may find out has the perfect excuse to deny the test. "I'm afraid of what it might tell me, and my dad doesn't want me to get it done, so I'll not get it done and I won't have to face anything that might happen." What a perfect avoidance excuse!!!
Bless your heart in having to deal with this situation. I know the fear and concern must be overwhelming. At the same time, your son is of age, albeit a young age. If he denies the test, you cannot force him to have it done. Support him as best you can, and don't let YOUR fear interfere with loving and caring for your family. If you forget to enjoy them while you have them, then you don't really have them at all.
Take care, I hope it all works out for you.
Can you ask him if he could give it a try (for you)? Explain how anxious you are, about even the remotest possibility of losing him. I try to remind my adult kids that sometimes we do things for other people, even if it's something we don't necessarily want to do. Wouldn't it be wonderful if the tests came back normal, and he could get on with his life knowing that his heart is healthy? Sounds like a low risk for a great benefit!
Good luck...please keep us posted.
wow, i would be like you scared for my son, and i guess thats what i would tell my son, do you want to be running and fall over dead from something that could of been prevented. tell him how inportant this is, does he want to be in the back of a ambulance again. its very hard when they are that age and can make up their own mind, but not understanding why dad would not want his son to be check good so that he would not have this problem, dad should be the one who cant live with self if something happens to son not you , your doing all you can, i know its breaking your heart , knowing your son needs this, pray it helps. God Bless you and your son, and i hope he does the loop