Implantable Loop Recorder

Your cardiologist may have referred you for an implantable loop recorder (ILR). This may be because you have been having symptoms such as dizzy spells, black-outs or palpitations that may be caused by an abnormal heart rhythm.

An ILR is a small metal device that is placed under the skin usually close to the breastbone. It continuously monitors the heart’s activity and can remain in place for up to 3 years. If you experience any symptoms you hold a hand held activator over the device and record the event which will be stored. These events can then be analysed by the cardiologist or cardiac physiologist (heart specialist) to see if an abnormal heart rhythm was the cause of the symptoms. Some ILRs allow you to send the recording to the ECG department by holding the activator over the phone. This will allow the doctors or technicians to look at the recording and take action if necessary. You will be advised on the day of your procedure about the type of ILR you have had implanted and how to use it.

The benefits of the ILR are that it constantly monitors your heart’s activity. If you experience symptoms you are able to press the activator and record the event. This can help to diagnose your symptoms.

Most medical procedures carry a risk of complications. Having an ILR carries a risk of:

• Infection at the wound site.
• Bruising or swelling to the site.

The risks are low: about 1 in every 100 procedures.

On the day of your procedure, you will be taken to the cardiac catheter lab.  The area near your breast bone will be cleaned with an antiseptic and a sterile sheet placed over you. Your skin will be numbed with local anaesthetic and a small incision will be made. A small pocket will be made under the skin and the ILR will be placed inside this pocket. The wound will be closed with sutures (stitches). The whole procedure will take about 30 minutes and you will be returned to a recovery area and be discharged a few hours later.

You will be given instructions on how to care for your wound before you are discharged from hospital. The sutures dissolve by themselves and do not require removal. Showering or bathing after the procedure is OK, but direct water contact on the dressing is best avoided. You will be advised when to remove the dressing.

A cardiac technician will program the ILR to the required settings usually before you are returned to the ward; this will only take a few minutes. The technician will show you how and when to use the activator. You will be given an information booklet and identification

(ID) card. You will be invited to attend follow up clinics to enable download the data on your recorder.

The ILR will be removed when your doctor has the information he needs to identify whether your symptoms are due to an abnormal heart rhythm or not. Removing the ILR is done as a day case and the procedure is similar to when it was implanted.