Implantable Loop Recorder

What is it?

If you have been experiencing symptoms of recurrent loss of consciousness, palpitations, light headedness, or dizziness, your doctor might advise that you require an Implantable loop recorder (ILR).

An Implantable loop recorder is a small, thin device inserted under the skin that monitors and records your heart’s electrical activity over a long period of time in order to identify an irregular heart rhythm. The ILR can determine whether your symptoms are related to a heart rhythm problem.

How is the ILR fitted?

The insertion of an ILR can be performed as a day case. You will be asked to fast (refrain from food and drink) for 4 hours before the procedure.

The device is inserted beneath the skin in the upper chest area after local anaesthetic has been use to numb the area.

The procedure takes approximately 15-20 minutes and once the device has been positioned under the skin the wound can then be stitched, usually with dissolvable stitches. A small dressing will be applied and you will be informed as to when you can remove it. You may be given antibiotics to minimize infection. The wound should be kept clean and dry until it is fully healed, although it is safe to bathe and shower.

What happens after the ILR is fitted?

At the time of your procedure your cardiologist will program the ILR to the required settings; this only takes a few minutes. Programming and data retrieval is done by radiofrequency, and this procedure is painless. Before you are discharged your cardiologist will explain how and when to use your activator.

How do I capture and record an episode?

An ILR can capture your heart’s activities during a blackout. This will allow your cardiologist to diagnose or rule out an abnormal heart rhythm.

To capture and record an episode, you are required to place a hand held activator over the ILR. When in place, press the button in order for the device to save the information. This should be done whilst experiencing symptoms or as near to the event as possible. The ILR has the ability to record what happened in the 4 minutes before the activator was pressed. If required a family member or friend can place the activator over the device to save the information.

The ILR can be set to automatically detect an abnormal rhythm without using the activator. It is still useful to use the activator when you have symptoms as this will show your cardiologist what your heart rhythm is doing when you are feeling unwell.

It is important to carry the activator with you at all times so that any episode can be recorded.

Regular follow-up of the recorded information will be arranged with your cardiologist. If you experience significant symptoms, and have pressed the activator, you can ring your cardiologist’s rooms and they will arrange for the information to be downloaded as soon as possible.

Remember that the device can only store the last 3 activations before it starts to overwrite the older recordings.

Removing your ILR

Once your heart’s activity has been recorded during your symptoms and your cardiologist is satisfied that any heart related causes are identified or ruled out, the device will be removed.

The removal of the ILR is similar to when you had it implanted and can be carried out in a day clinic.

Following discharge

  • If you have a temperature please let the hospital / cardiologist know
  • If you are unsure about your medication please contact your doctor
  • • Whilst the site is healing, avoid wearing tight clothing that could rub and cause your discomfort over the site of the recording device
  • Let the hospital know immediately if your wound becomes red or swollen or starts to ooze
  • You can shower/bath as normal, but you must keep your wound dry. You will be advised if you need removal of sutures
  • Always carry your ILR device details with you. Dentists, doctors, emergency personnel and some security personnel (e.g., at airports) will need to know that you have an ILR device

Other precautions

The device casing is made out of titanium and is not magnetic and has no moving parts. However, you should avoid devices which generate a strong or electro-magnetic interference (EMI). This could cause the device to malfunction and fill the memory with interference. This means that you may have to have your device reviewed after an MRI.

Important safeguards

  • Do not use the patient activator whilst bathing
  • Do not place the activator near water
  • Do not drop the activator into water or other liquids

What to do if the activator is damaged or lost

Please contact your cardiologist’s rooms as soon as possible and the device company can arrange for a replacement.

If you are a patient undergoing this test and you have any further queries, please phone (08) 8297 6888 or raise them with your cardiologist.

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