Implantable Loop Recorder (ILR)
What is an implantable loop recorder (ILR)?
An implantable loop recorder (ILR) is a small device that continuously monitors heart rhythms and records them both automatically and/or by using a hand-held patient assistant. An ILR is designed to help Dr. Ahuja quickly diagnose and treat abnormal heart rhythms that may be related to unexplained fainting, dizziness, palpitations, or strokes.
• An ILR is surgically placed just under the skin of your left chest
• An ILR is very small, and often not visible in most patients
• It automatically detects and records abnormal heart rhythms for up to 3 years
• It’s safe for use in an MRI setting
Benefits and Risks
Benefits: By looking at your heart rhythm before, during, and after an episode, Dr. Ahuja may be able to identify whether the cause of your symptoms is heart rhythm related. If an arrhythmia (i.e. abnormal heart rhythm) is found, then Dr. Ahuja may recommend specific therapy based on that exact arrhythmia. Future treatments may include things such as a pacemaker, defibrillator, an electrophysiology study, or long-term treatment with blood thinners. If your heart rhythm can be ruled out as a cause of your symptoms, then Dr. Ahuja can focus on other potential causes of your symptoms, such as neurologic causes.
Risks: All surgical procedures carry some risk. As an ILR is inserted just beneath the skin, there is a slight risk of infection, and/or allergy to the cardiac monitor material. If an infection occurs, the ILR should be removed and you should be treated with antibiotics.
The ILR is implanted in a sterile operating room such as the Electrophysiology Lab. A small amount of sedation can be administered to reduce anxiety. The skin will be cleaned to make sure the procedure is done under sterile conditions. Local pain medication will be given over the operative site. Next Dr. Ahuja will create a small “cut” in the skin, through which the ILR is implanted.
STEP 1 – a small incision with a blade
STEP 2 – the ILR is placed with a plunger
STEP 3 – the ILR is injected under the skin
STEP 4 – the incision is closed with a suture
The “cut” is closed with 1 absorbable suture and then covered with liquid glue or a small sterile dressing. The procedure takes 5-15 minutes, and patients can go home the same day. Once the ILR is inserted, it is programmed to continuously monitor your heart rhythm. When your symptoms occur (such as a fainting spell), you or your family member can immediately place the small hand-held patient assistant over the device and press the record symptoms (heart-shaped) button. This triggers the device to record the heart’s rhythms before, during, and after the symptoms.
After you have recorded a fainting spell, the recording will be sent to Dr. Ahuja through your home monitoring system. He will call you if your heart rhythm is abnormal.
Frequently Asked Questions:
If I get an implantable loop recorder, will I have to change my daily routine?
In general, people who get an ILR can perform almost all their normal activities. You can swim, bathe, and exercise with your device without fear of harming it. Your doctor may ask you to limit some of your activities because of your unexplained fainting or until your incision heals.
How long will I have an ILR?
Your doctor will determine how long the ILR is used. Typically after one or more heart activity recordings are made, your doctor will determine if your symptoms are related to an abnormal heart rhythm. At that time, the device can be removed in a quick and simple procedure.
Can I have an MRI done while I have an ILR?
The new ILRs have been demonstrated to pose no known hazards in a specified MRI environment. There is usually no MRI waiting period after the insertion procedure. Let your physician or MRI clinic staff know you have an ILR and present your device certification card to them.
Following up after Surgery
The device will start recording your heart rhythm instantly. When you setup your home monitor, the transmissions will be automatically sent to Dr. Ahuja. A routine appointment will be made 4-6 weeks after implantation to make sure the wound is healing properly. After that appointment is usually made every 6 months to review the findings on the ILR. If an abnormal heart rhythm is found, Dr. Ahuja will contact you over the phone to discuss the results.