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Loop Recorder Implantation

A loop recorder implantation is the placement of a cardiac monitor that continuously records the heart’s electrical activity under the skin. The implantable loop recorder (ILR) records electrical activity when the heart beats normally and abnormally. This information is sent through a receiver or accessed when the programmer from the manufacturer inspects the machine. This allows continuous monitoring of the heart’s electrical activity through the receiver.

Preparing for the Procedure
  1. Avoid food and water for at least six to eight hours before the procedure or as recommended by the doctor.
  2. Please let your doctor know about all medication that you are taking as some may need to be stopped before the procedure.
  1. The procedure is done in the Cardiac Electrophysiology Laboratory (EP Lab).
  2. You will be given fluids and medication intravenously.
  3. Equipment will be attached to monitor your vital signs during the procedure.
  4. You will be given a sedative intravenously that will make you sleepy and relaxed. The doctor will inject a local anesthetic into the area under the collarbone on the side where the implantable loop recorder (ILR) will be placed.
  5. The doctor will make an incision about one centimeter long under the collarbone and the implantable loop recorder will be placed under the skin.
  6. An officer from the manufacturing company will test the signal of the implantable loop recorder. When it is appropriately calibrated the doctor will suture the implantable loop recorder and close up the incision.
  1. You will rest in a patient room and be monitored closely for four to six hours. If you do not experience any complications you can return home the same day.
  2. You may experience some pain at the incision.
  3. Avoid strenuous activity and do not lift or extend the arm on the affected side for at least 24 hours.
  4. Please keep follow-up appointments with your doctor to check the results of the implantable loop recorder. The batteries of the implantable loop recorder can usually last up to three years.
  1. Swelling, bleeding, or infection at the insertion site.
  2. Allergic reaction to the medication received during the procedure.
  3. Pneumothorax.
  4. Blood clot, leading to a stroke or heart attack.
  5. Death, which is rare.
Let your doctor know if you develop problems, such as:
  1. Bleeding, swelling, or increased pain at the implantation site
  2. Fever
  3. Chest pain
  4. Difficulty breathing
  5. Fainting
Before the Procedure
  • You should plan to stay in Thailand for at least three to seven days through the duration of your treatment.
  • It is recommended that you stay in a hotel close to the hospital for convenience in traveling to the hospital before and after the procedure or from the day of the procedure to the day of your follow-up appointment.
After the Procedure
  • At your follow-up appointment you will undergo a physical examination and your wound will be checked. You will receive documentation regarding your surgery or procedure and all other relevant documentation for traveling.
  • The incision site may be bruised, which is normal after the procedure. The bruise will resolve on its own within one to two weeks. If a hematoma develops or if there is uncontrolled bleeding from the incision or if the site shows signs of inflammation, such as swelling, redness, warmth, and/or severe pain, please see your doctor immediately.
  • If you develop a fever or if you become lightheaded or faint, please see your doctor immediately to determine the cause of these symptoms.
  • Before you are discharged, the doctor will change your bandage, which can be removed after one week or at your follow-up appointment to check the wound. The incision will be covered with a paper or thin tape after that. Do not remove it. The tape will slowly dissolve when you bathe.
  • Always carry your loop recorder card to provide preliminary information to any doctor that you see if you must travel to another province or country. Show the card when you go through airport check points with metal detectors as the loop recorder may show up as suspicious and set off alarms because of the metal it is made with.
  • When traveling by air, if you are seated in Economy Class, please choose an exit row or bulkhead seat for convenience in getting up and moving around every 15-30 minutes. Flex your ankles regularly to prevent deep vein thrombosis.
  • Please take all medication prescribed by your doctor. Carry the appropriate dosage of mediation in your carry-on luggage when you travel as well as a few extra doses in case of an emergency. Carry the prescription for all your medication to avoid problems at the airport.
The success rate of the procedure depends on many factors. Please discuss this with your doctor.
 
What if the procedure is not performed?
The implantation of an implantable loop recorder is part of the treatment of arrhythmias, recording the heart’s electrical activity continuously so the doctor can diagnose and treat problems with the heart’s rhythm quickly. The implantable loop recorder also allows the doctor to closely monitor the results of treatment.
 
Alternatives
  1. Electrocardiogram (EKG).
  2. Holter/24 hour dynamic electrocardiography monitoring.
  3. Occasional monitoring of cardiac activity.

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