Overview of Implantable Loop Recorder
Walking around with a device that keeps track of your heart’s electrical activity, otherwise known as an ambulatory electrocardiogram (ECG) monitor, can help doctors to check and identify any unusual heart symptoms you might have. There are several different types of these monitors. The Holter monitor records your heart’s activity for 24 to 48 hours. Event monitors can capture 2 to 4 hours of heart activity. And then there are Implantable loop recorders which can record your heart’s activity for up to 3 years.
The type of monitor required will usually depend on how often your symptoms occur. If you get symptoms daily, a Holter monitor is probably enough. If your symptoms happen weekly or monthly, an event monitor might be better. But if your symptoms don’t show up very often – less than once a month or even just a few times a year – an Implantable loop recorder is likely the best option. Some event recorders might not be very helpful if you collapse and can’t turn the device on. That’s why it’s usually better to have a device that turns on by itself or stores information for later retrieval. This text is going to focus on Implantable loop recorders
The Implantable loop recorder, or ILR for short, is a device that is placed under your skin to monitor the electrical activity in your heart for a longer period. This is different from ECGs that provide a snapshot of your heart’s electrical activity at a given moment. The ILR allows doctors to keep an eye on your heart over a longer period of time.
Why do People Need Implantable Loop Recorder
An implantable loop recorder is a device often used by doctors to find out why someone might be having regular heart palpitations or fainting spells with no clear cause. It’s like a long-term heart monitor that can be particularly useful when other short-term tests haven’t provided a clear answer.
This device can also be beneficial in other situations such as:
- Finding hidden episodes of atrial fibrillation (an irregular and often rapid heart rate) that don’t cause symptoms but have occurred after a stroke.
- Monitoring the average heart rate or checking how well the rate is controlled in a patient with atrial fibrillation (a heart condition causing an irregular and often abnormally fast heart rate).
- Evaluating slow heart rate episodes before implanting a permanent pacemaker (a device that helps to regulate the heart’s rhythm).
- Checking for symptom-free instances of unusual heart rhythms or rapid heartbeats in patients with inborn or acquired heart conditions.
- Evaluating a patient’s prognosis (likely outcome) after a sudden heart problem.
When a Person Should Avoid Implantable Loop Recorder
A definite reason not to put in a loop recorder, a device used to track heart rhythms, is when there’s no real need for it. Other possible reasons, although less absolute, include if the person has an active infection, or a condition that makes them bleed easily. These conditions could delay the procedure for a while.
Equipment used for Implantable Loop Recorder
The implantable loop recorder is a tiny device, roughly the size of a USB flash drive, that has two built-in electrodes. As mentioned before, the battery of this device can last up to three years.
How is Implantable Loop Recorder performed
A small cut is made on the left side of your chest, around the area of your second or third rib. A space is formed under your skin to place the device. The device is then put into this space and the cut is closed up. This procedure is usually done by an electrophysiologist, a doctor who specializes in our heart’s electrical system. This is generally a simple procedure that doesn’t require a hospital stay and only needs local anesthesia to numb the area where the cut is made. Some patients might be given a medicine to help them relax but it’s not usually necessary. Once the device is in place, it’s activated by running a magnet over it.
Possible Complications of Implantable Loop Recorder
The most frequent issue some people experience after getting an implant is discomfort or pain where the device was put in. There are potential risks with this procedure such as an infection where the implant is located, which could necessitate the removal of the device. Alternatively, there may be a local skin reaction to the device. There’s also a small chance that the device may not adequately detect the R-wave, a particular point in the heart’s electrical rhythm. If this happens, it may need to be relocated to a different area of the body.
What Else Should I Know About Implantable Loop Recorder?
An implantable loop recorder is a device that keeps a record of your heart rate and rhythm. It’s a bit like a small diary for your heart that is implanted under your skin. This device can store events activated by the patient, events activated automatically, or a mix of the two. A typical report from a loop recorder includes data about your heart rhythm (ECG), which a technician will interpret, and details about any symptoms you’ve experienced and how long they lasted. This information can assist your doctor in figuring out what might be causing your symptoms.
Implantable loop recorders are some of the most effective tools in identifying the cause of unexplained fainting (syncope), detecting it up to 75% of the time in the course of 3 years. You don’t have to remove them when showering, swimming, or sleeping. They allow you to carry on with your day-to-day life and even exercise freely. Upon implanting, doctors usually provide an ID card with details about your specific device, which can be helpful in emergencies where hospital staff need to check the device. What’s key about this device is that it records your heart’s electrical activity and it’s safe to use around other electrical devices. Other heart monitors may be used but are typically not as effective unless symptoms happen every day, which isn’t typical for most patients.
After the monitoring, there could be three possible outcomes. If you experienced symptoms and the device records abnormal heart rhythms during these episodes, your doctor will suggest a suitable treatment. This could be a permanent pacemaker or defibrillator, a special examination of your heart’s electricity followed by a treatment, or maybe a medication to thin your blood if you have an irregular heartbeat (atrial fibrillation). The second possibility is that you had symptoms but the device showed normal heart rhythms. In this case, your symptoms are likely not heart-related and your doctor will explore other causes. The final scenario is if you had no symptoms and your heart rhythms were normal during the monitoring period. In this instance, your symptoms probably aren’t heart-related and you won’t need further heart monitoring. In any case, once the required information is obtained or if no abnormalities were found, the device can be removed through a similar method to its implantation.
Implantable loop recorders are safe and very effective in identifying any heart rhythm problems. This device is usually considered after you’ve had a detailed history check and physical examination. Your doctor will also take into account factors like your family history and medications you are taking. Initial tests usually include an ECG and an echocardiogram (a heart ultrasound), which can reveal structural problems in the heart. Additional tests, like a stress test or a tilt table test, might be beneficial depending on your symptoms. If you keep having symptoms and all other tests showed nothing, then implanting a loop recorder could be a good next step for certain patients.
