Implantable Loop Recorders (ILR): A guide for cardiac patients

What is a Loop Recorder?

A loop recorder is a small device, (around the size of a small USB stick) that records your ECG trace for around 3 years. It is designed to capture any abnormalities relating to the conduction system or “electrics” of your heart that maybe making you unwell. The loop recorder is linked to an app or home monitoring device via Bluetooth, whereby all the data is sent to us, at The Great Western Hospitals (GWH) in Swindon and analysed by cardiac physiologists. If an abnormality is found, we contact you and treat the cause.

Why might I need a loop recorder?

There are many reasons you may require a loop recorder, the most common are:

Syncope with unknown cause
Events that make you unwell and could be of cardiac nature.
Suspicion of cardiac arrhythmias that have not captured on other cardiac tests.

Preparing for the procedure

As this is a quick procedure under local anaesthetic, there is minimal preparation to be done, here are a few considerations:

Have a nice bath or shower before the procedure day, as you cannot get the area wet for 5 days post ILR implantation.
Remember to eat and drink before the procedure.
Bring a list of any medications you are currently taking.
Please allow an hour for the appointment
No heavy lifting or pulling for 1 week.

Implantation

On the day, there will be time to ask any questions and sign a consent form. The implant of an ILR is a quick procedure, the only discomfort you may feel, is the local anaesthetic used to numb the area for the device to be injected in under the skin over the left pectoral area. The incision which is about one cm wide, is then closed with surgical adhesive or a dissolvable stitch.

Recovery

The “5 day rule”-keep your dressing dry and clean for 5 days then it can be removed. This is to allow time for the incision to heal over. Some patients experience bruising around the area of implantation or discomfort post procedure, this is perfectly normal and will pass once it is healed.

There are no restrictions to your daily life once the ILR incision site has healed. As there are metal components, you may be required to show evidence of your device at the airport, we will provide you with a card stating this information.

How do I know if my device is working?

I like the saying “no news from us is good news”, this means we have not seen anything to worry about and that we are still receiving data from your loop recorder. We will contact you if we fail to receive data or receive data that maybe related to your symptoms.

Once the ILR device has been implanted, we do not need to see you unless you have concerns with wound healing. That is the beauty of virtual monitoring! However, should a question arise, a contact number will be provided.

What if I experience symptoms?

If you have experienced symptoms such as unexplained palpitations, blackouts or dizziness, the ILR would help to capture the abnormal heart rhythms (arrhythmia) that might otherwise go undetected. When the ILR detects an irregular rhythm such as atrial fibrillation, pauses or slow heart rate, it will automatically record the event.

The cardiac physiologists at the Great Western Hospital will review the recording and will inform your cardiologist regarding the findings. If an arrhythmia has been detected, your cardiologist will tailor a treatment plan. This will either include medications, ablation procedure or pacemaker implantation to effectively manage the underlying issue.

Detecting the exact type and timing of the underlying arrhythmia is the key to make an accurate diagnosis and guide the most appropriate management plan.

Author

Kyra Sullivan

Specialist Cardiac Physiologist – Great Western Hospital Swindon