A loop recorder implantation is the placement of a cardiac monitor that continuously records the heart’s electrical activity under the skin. The implantable loop recorder (ILR) records electrical activity when the heart beats normally and abnormally. This information is sent through a receiver or accessed when the programmer from the manufacturer inspects the machine. This allows continuous monitoring of the heart’s electrical activity through the receiver.
You might need a loop recorder if you have fainting episodes or palpitations, and other tests have not yet given you any answers. Repeated fainting can have a negative effect on your physical and emotional health. Also, certain kinds of fainting greatly increase your chance for sudden death. These fainting episodes require diagnosis and treatment as soon as possible. Once you are diagnosed, you may need a pacemaker or an implantable cardioverter-defibrillator (ICDs). These could save your life. You might also need a loop recorder if your healthcare provider wants to look for very fast or slow heartbeats. These abnormal heartbeats can cause palpitations, or even lead to strokes. If you have a problem with fainting, your healthcare provider will look at various causes. Only certain kinds of fainting are due to abnormal heart rhythms. Your healthcare provider will probably start with basic tests like an electrocardiogram (ECG). This records your heart rhythm only for a few seconds, however. So, your healthcare provider may not be able to analyze the specific rhythm problem that causes your fainting. He or she might have tried other sorts of tests, like Holter monitoring, tilt-table testing, or electrophysiologic studies of your heart. Loop recorder implantation is often helpful if other tests haven’t found the cause. Your healthcare provider is more likely to recommend it if your heart is a likely cause of your fainting. This is more common in the elderly. It is also more common in people with other heart problems. You are also more likely to need loop recorder implantation if you are fainting frequently, but not enough for other kinds of heart rhythm monitoring to detect your fainting. Because the loop recorder records for up to 3 years, your healthcare provider should eventually be able to analyze your heart rhythms during a fainting episode. You also might need a loop recorder if you are an older adult with unexplained falls. Healthcare providers sometimes use it in people believed to have epilepsy who have not responded to medicine. In both cases, the recorder can determine whether an abnormal rhythm is the problem.
-An implantable loop recorder can help answer questions about your heart that other heart-monitoring devices don't provide.
-It allows for long-term heart rhythm monitoring.
-It can capture information that a standard electrocardiogram (ECG or EKG) or Holter monitor misses because some heart rhythm abnormalities occur infrequently.
-Because an implantable loop recorder monitors your heart signals for a much longer time, it's more likely to capture what your heart is doing during your next fainting spell. This information may help your doctor make a definite diagnosis and develop a treatment plan.
The most significant disadvantage when it comes to loop recorders is the high initial cost associated with it. In the case of implantable recorders, the need for a surgical operation to get the recorder attached can also be a slightly discomforting news to some.
-Sensors in the recorders can malfunction and start storing ineffective information which can exhaust the memory of the recorder over a period of time.
The procedure is done in the Cardiac Electrophysiology Laboratory (EP Lab). You will be given fluids and medication intravenously. Equipment will be attached to monitor your vital signs during the procedure. You will be given a sedative intravenously that will make you sleepy and relaxed. The doctor will inject a local anesthetic into the area under the collarbone on the side where the implantable loop recorder (ILR) will be placed. The doctor will make an incision about one centimeter long under the collarbone and the implantable loop recorder will be placed under the skin. An officer from the manufacturing company will test the signal of the implantable loop recorder. When it is appropriately calibrated the doctor will suture the implantable loop recorder and close up the incision.
Avoid food and water for at least six to eight hours before the procedure or as recommended by the doctor. Please let your doctor know about all medication that you are taking as some may need to be stopped before the procedure.
You will rest in a patient room and be monitored closely for four to six hours. If you do not experience any complications you can return home the same day. You may experience some pain at the incision. Avoid strenuous activity and do not lift or extend the arm on the affected side for at least 24 hours. Please keep follow-up appointments with your doctor to check the results of the implantable loop recorder. The batteries of the implantable loop recorder can usually last up to three years. The device records the electrical impulses of your heart and transmits them automatically to your doctor by way of the internet and wireless technology. All you need to do is keep the transmission monitor your doctor gives you beside your bed. Transmissions occur while you're asleep. You can also activate the data transmission process yourself. In addition, your doctor may ask you to keep a diary of your symptoms. Your doctor will interpret the results of your test and call you if he or she has any concerns. You'll likely need to see your doctor once or twice a year for routine checkups while the device is in place. An implantable loop recorder is invisible and doesn't interfere with your daily activities. It has no patches or wires, and you don't have to worry about getting the device wet while bathing or swimming. These devices are supposed to be safe for use during a medical imaging procedure called magnetic resonance imaging (MRI), but let your doctor know about your implant before you schedule such a test. It's also possible an implantable loop recorder might set off metal detectors, for example, at an airport. Your doctor can provide you with a device identification card to carry with you for such situations.
All procedures have some risks. In general, the risks of this procedure include: Swelling, bleeding, or infection at the insertion site. Allergic reaction to the medication received during the procedure. Pneumothorax. Blood clot, leading to a stroke or heart attack. Death, which is rare. Let your doctor know if you develop problems, such as: Bleeding, swelling, or increased pain at the implantation site Fever Chest pain Difficulty breathing Fainting Your own risks will depend on your age, your other overall health, and other factors. Talk with your healthcare provider about the risks that most apply to you.
What are the travel restrictions for this procedure?
Before the Procedure:: You should plan to stay in Thailand for at least three to seven days through the duration of your treatment. It is recommended that you stay in a hotel close to the hospital for convenience in traveling to the hospital before and after the procedure or from the day of the procedure to the day of your follow-up appointment. After the Procedure: At your follow-up appointment you will undergo a physical examination and your wound will be checked. You will receive documentation regarding your surgery or procedure and all other relevant documentation for traveling. The incision site may be bruised, which is normal after the procedure. The bruise will resolve on its own within one to two weeks. If a hematoma develops or if there is uncontrolled bleeding from the incision or if the site shows signs of inflammation, such as swelling, redness, warmth, and/or severe pain, please see your doctor immediately. If you develop a fever or if you become lightheaded or faint, please see your doctor immediately to determine the cause of these symptoms. Before you are discharged, the doctor will change your bandage, which can be removed after one week or at your follow-up appointment to check the wound. The incision will be covered with a paper or thin tape after that. Do not remove it. The tape will slowly dissolve when you bathe. Always carry your loop recorder card to provide preliminary information to any doctor that you see if you must travel to another province or country. Show the card when you go through airport check points with metal detectors as the loop recorder may show up as suspicious and set off alarms because of the metal it is made with. When traveling by air, if you are seated in Economy Class, please choose an exit row or bulkhead seat for convenience in getting up and moving around every 15-30 minutes. Flex your ankles regularly to prevent deep vein thrombosis. Please take all medication prescribed by your doctor. Carry the appropriate dosage of mediation in your carry-on luggage when you travel as well as a few extra doses in case of an emergency. Carry the prescription for all your medication to avoid problems at the airport.
How does an implantable loop recorder work?
The loop recorder makes a recording of your heart rhythm if it detects that your heart is beating abnormally, or if you use the hand-held activator that comes with it. When you experience symptoms, you can place the activator over the implantable loop recorder and press a button that tells the device to make a recording. Usually it can capture a recording starting a few minutes before, so don’t worry if the symptoms stop when you press the button.
What is the recovery like?
You may feel a bit bruised and sore where the skin is cut, but this will get better quickly. As long as you feel well, you can go home and get on with your day as normal. Longer term, you might be able to feel it but it shouldn’t hurt.
Can I do things I normally do while I have one?
It is fine for you to go about your day-to-day life straight away. If you feel any symptoms or palpitations, you can use the hand-held activator if you have it with you, and make a note of where and when it happened and what you were doing at the time, to discuss with your doctor when you get the results through. The implantable loop recorder shouldn’t restrict your normal life. You can go through security scanners safely, although you may set off metal detectors – show your device identification card if this happens. In most cases you can take it abroad if you are going on holiday. Ask your specialist for detailed advice.