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Understanding Loop Recorder Implantation

An implantable loop recorder (ILR) is a device that records information about how your heart is working. A loop recorder may be implanted if you have problems such as:

  • Fainting, dizziness, or lightheadedness

  • Heart palpitations

  • Very fast or slow heartbeats

  • Unexplained falls

  • Possible hidden heart rhythm problems that can cause strokes, such as atrial fibrillation

  • Certain gene disorders

During implantation, a small device is placed under the skin on your chest, overlying the heart. The device works as an electrocardiogram (ECG). It constantly picks up electrical signals from your heart. An ILR records for up to 3 years.

How a loop recorder helps

You may need an ILR if other tests haven’t found the cause of your symptoms. An ILR constantly records your heart’s electrical activity. For example, if you faint because of an arrhythmia, the device records your heart’s activity before, during, and after you faint. Then your healthcare provider can see how your heart was acting.

Or you may need to trigger your ILR with an activator. This is a small, handheld device. You press a button on the activator when you are feeling symptoms. The ILR then records your heart’s activity. This device is very useful when you don't have symptoms often or if your provider needs to look at information about your heart over a longer period of time. Additionally, a monitoring device may be set up at your home to send data to your healthcare provider that is either triggered by you or picked up automatically be your device.

Once the cause of your symptoms is found, you can be treated. You may need another small device to help control your heart rhythm. This may be a pacemaker or an implantable cardioverter-defibrillator (ICD).

How loop recorder implantation is done

The healthcare provider will first clean the area, inject local numbing medication, and make a small cut (incision) in your skin just to the left of your breastbone (sternum). You may be covered with sterile cloths (drapes) to protect the area from infection. An insertion tool will then be placed under the skin where the cut was made. This creates a pocket for the recorder to sit in. The recorder is then placed under the skin and the tool is removed. Afterward the cut is typically closed with either surgical glue, stitches (sutures), staples, or steri-strips. The ILR is about the size of a AAA battery. The loop recorder can be felt when pressing on the overlying skin and may protrude slightly. Typically it is not noticeable.

Your healthcare provider can remove the recorder in a similar way once enough information has been recorded or once the battery life ends.

Risks of loop recorder implantation

All procedures have some risks. In general, the risks of this procedure include:

  • Bleeding or bruising

  • Infection that may require that the ILR be removed

  • Mild pain at the insertion site

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.

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