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Loop Recorder Implantation

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Understanding the Role of an Implantable Loop Recorder (ILR)

The Implantable Loop Recorder (ILR) is a compact, technologically advanced device specifically designed to continuously monitor and record your heart's electrical activity (ECG). It springs into action whenever it detects any abnormalities, documenting vital data for further medical analysis. Importantly, it also empowers patients to manually trigger a recording during episodes of dizziness or perceived skipped beats.

Often, ILR is deployed to pinpoint the cause of recurring unexplained fainting (syncope), especially when other simpler tests return normal results, but there is a strong suspicion of a heart rhythm anomaly. The device, nestled just under the skin of the chest, is introduced through a minor surgical procedure.

If you're considering a loop recorder placement, entrust your care to Dr Karthigesan. His unparalleled expertise in cardiac procedures ensures you receive the highest quality care for your heart. Contact Dr Karthigesan today and move forward with confidence in your heart health journey.

Image of an Implantable Loop Recorder (ILR).
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Image of an Implantable Loop Recorders (ILRs) with the insertion tool.
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Types of Implantable Loop Recorders (ILRs)

Implantable Loop Recorders come in two main variants:

Traditional Loop Recorders
These are the original form of ILRs, which are usually 2.5 inches in length. The method of implantation for these devices typically involves a minor surgical procedure.
Newer or Injectable Loop Recorders
This recent innovation in the field of ILRs offers a more streamlined design, with the devices being approximately 1.5 inch long. These ILRs, often referred to as 'injectable', are implanted using a less invasive technique.
The image shows an implanted Loop Recorder.

Assessing the Need for Loop Recorder Implantation

The appropriateness of an Implantable Loop Recorder for you is determined by Dr Karthigesan through a comprehensive evaluation. This typically involves:
  • Reviewing your detailed medical history.
  • Performing a thorough physical examination.
  • Conducting a series of tests, including:
  • Electrocardiogram (ECG/EKG)
  • Exercise stress test
  • Echocardiogram
  • Tilt table test
  • Holter monitor test
  • External loop recorder (ELR)

If these tests fail to identify any heart issues yet continue exhibiting symptoms like palpitation or fainting, you might need an ILR to get to the root of your symptoms.

Who Needs Loop Recorder Implantation?

People with:

  • Unexplained palpitations
  • Recurrent syncope
  • Recurrent brain stroke
  • A need for long term heart monitoring for any other indications

The Procedure for Loop Recorder Placement

The Implantable Loop Recorder, roughly the size of a computer USB stick or even smaller, is positioned underneath the skin on the chest. Notably, there are no wires connecting it to the heart. This device is implanted under local anaesthesia as an outpatient procedure, providing a continuous recording of your heart's activity. This helps to diagnose heart rhythm disorders and the cause of unexplained fainting (syncope). Once the diagnosis has been made, the device can be removed. Here's a brief outline of the procedure:

  • You might receive a mild sedative to ensure you are relaxed and comfortable during the procedure.
  • Local anaesthesia is applied to numb the area, minimising any discomfort you may feel.
  • A small bruise is made, through which the device is inserted.
  • After successful placement, the bruise is closed.
  • The procedure typically lasts about 10 to 15 minutes.

The ILR remains in place for up to three years, monitoring your heart's activity. When the device detects an irregularity, it can automatically initiate a recording, or you may need to do so manually. You can trigger a recording by:

  • Utilising a small, handheld activator device when you experience symptoms.
  • Using a compatible mobile phone app to initiate the recording manually.
The image shows the working of an implanted Loop Recorder with its reading shown as signals.

Loop Recorder Implantation: Before, During & After Procedure

  • Follow your doctor’s advice regarding medication intake leading up to the procedure. Remember, don't discontinue any medication unless you are advised to.
  • You may be asked to refrain from eating or drinking few hours prior to your procedure.
  • A local anaesthetic will be applied to numb the area of insertion.
  • The doctor will make a small bruise, typically in the left upper chest.
  • A small pocket will be created under your skin to place the loop recorder, approximately the size of a flat AAA battery.
  • The bruise will be closed with sutures, and a bandage will be applied over the area.
  • You will typically be discharged on the same day. Pain medication will be available if needed.
  • While you can return to normal activity post-procedure, it is better to rest initially.
  • If you notice any bleeding or swelling at the insertion site, inform Dr Karthigesan promptly.

Benefits of Implantable Loop Recorder Placement

  • The ILR provides prolonged monitoring of your heart's electrical activity for up to three years, covering a much broader time frame compared to other monitoring devices.
  • This device is capable of automatically recording abnormal heart activity, reducing your need to manually activate it. This means it can detect irregularities even when you're asymptomatic.
  • Research indicates that loop recorders are often successful in detecting cases of symptomless  atrial fibrillation.
  • With an ILR, you can continue your normal routine, including activities like swimming and bathing. As the device is hidden under the skin, it remains unnoticeable.
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Experience Unparalleled

Heart Monitoring

The loop recorder implantation managed by Dr Karthigesan is designed to continuously monitor and record your heart's electrical activity. Let's ensure that your heart remains in rhythm!

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Loop Recorder Placement: Your Questions, Our Answers

ILR is typically suggested for patients manifesting recurrent symptoms such as syncope (fainting), seizures, palpitations, lightheadedness, recurrent brain stroke, or dizziness. It's particularly beneficial for individuals who experience these serious symptoms sporadically due to heart rhythm abnormality, not frequently enough to be detected by a 24-hour or 30-day external monitor.

The ILR, with its three-year battery life, offers extended and constant monitoring of heart rhythm 24/7. This allows physicians ample time to capture and evaluate any abnormal heart rhythms.

Unlike a pacemaker, a loop recorder doesn't alter your heart’s electrical activity. Its primary role is to monitor and detect irregular heart rate and rhythm. On the other hand, a pacemaker actively intervenes to correct abnormal heart rhythms, often slow rhythms. It sends electrical signals to regulate the heartbeat when irregularities are detected. Should an arrhythmia requiring long-term treatment be revealed by the loop recorder, implantable devices such as a pacemaker or an implantable cardioverter defibrillator might be recommended.

The implantation of a loop recorder is typically conducted by an electrophysiologist - a cardiologist like Dr Karthigesan, who specialises in the heart’s electrical system.

Please reach out to Dr Karthigesan immediately if you notice any symptoms like syncope (fainting), seizures, palpitations, lightheadedness, recurrent brain stroke, or dizziness. He will be carrying out a device checkup immediately.

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