Cardiology
Implantable Loop Recorder Implant Procedures
Patient Information Leaflet
Introduction
You have been given this leaflet as your doctor has suggested you would benefit from having a monitor implant. This leaflet gives more information on what will happen to you before and after the procedure. It is designed to make sure that you know as much as possible about the procedure before you agree to it and sign the consent form.
What is a Loop Recorder?
A Loop recorder (ILR) is a small electronic device, that is implanted in the chest. It monitors your heartbeat and when required, records your heart rhythm.
An ILR consists of a battery and recording circuity.
Most ILRs are powered by a lithium-ion battery and last between 2 and 6 years.
Implantation of the ILR is a surgical procedure performed under local anaesthetic. It usually takes 15- 20minutes to perform.
Most procedures can be done as a day case. If there are no complications, you will be allowed to go home after one hour.
Why do I need an ILR
An ILR implantation will only be requested by your doctor if they feel this is the best way to monitor heart condition and symptoms. The ILR will record any fast or slow heart rhythms automatically. You may be given an activator to make the ILR take a recording when you experience your symptoms. The recordings help the doctor find the best treatment for your condition.
Consent
We must seek your consent for any procedure or treatment beforehand which will be a two-stage process.
Stage one will be with your doctor/ advanced practice healthcare professional in a clinic setting where they will explain the risks, benefits and alternatives where relevant, before they ask for your written consent. If you are unsure about any aspect of the procedure or treatment proposed, please do not hesitate to ask for more information.
Stage two will be a re-confirmation when you attend for the procedure and will be undertaken by a healthcare professional (either physiologist or the operator
What are the benefits of having this procedure?
The ILR will take automatic heartbeat recordings
You will be able to take recording when you experience your symptoms
What are the risks of having this procedure?
- Pain of local anaesthetic being administered
- Bleeding from the insertion site.
- Blood collection (haematoma) at the insertion site.
- Small risk of surgical wound infection.
What if I decide not to have an ILR implant
If you choose not to have an ILR implant you could discuss with the doctor an alternative recording device.
What preparation is needed?
On the day of the procedure:
- Eat and drink as normal.
- Bring all medication with you.
- Please take your normal medications, with a sip of water on the morning of your procedure- see the note regarding Warfarin and anticoagulation
- Have a bath or shower.
- Remove jewellery, contact lenses, make-up and nail varnish. Wedding rings can remain but will be taped for the procedure.
- Bring a book or something to do whilst you wait.
- Bring reading glasses.
- Avoid bringing large sums of money or valuables.
- You may want to arrange for a relative or a friend to take you home after your procedure by car/taxi.
- Medication
What to do if on Warfarin or newer anticoagulants (NOACs):
- Stop anticoagulation (Apixaban, Dabigatran, Edoxaban or Rivaroxaban) 48 hours before the procedure.
- Warfarin, please contact the day case unit 01384 456111 ext. 2573 to discuss when to take your last dose.
Diabetes (controlled by diet or tablets)
Eat and drink as normal
Diabetic taking insulin:
Eat and drink as normal
What happens on the day:
- We will provide you with a gown to change into. Pre-procedure tests will include blood pressure, temperature, and ECG.
- A healthcare professional will discuss your stage two consent. Please use this opportunity to raise any concerns that you may have.
- A physiologist will discuss the ‘Living with a Loop Recorder’ information sheet and homemonitoring.
- A post operative appointment will be arranged for 6-8 weeks in the device’s clinic.
What happens during the procedure
The procedure is performed in a dedicated room within the Cardiology Department. You will be cared for by a team of doctors, nurses, and cardiac physiologists.
- You will lie on a bed.
- Your ECG, blood pressure and oxygen levels will be monitored throughout the procedure.
- Your upper chest will be cleaned with a cold antiseptic and covered with sterile drapes. We will make a gap so you can peep out.
- After injecting the area with local anaesthetic, a small incision is made, and a pocket formed behind the skin where the ILR will sit.
- The physiologist will run a series of tests on the ILR.
- Your incision will be closed with and a dressing applied.
- You will be taken back to recover in the Day Case Unit.
What happens after the procedure?
- You will be taken back to recover in the Day Case Unit.
- Your heart rate, blood pressure and wound site will be monitored.
- You will be given something to eat and drink.
- You can have painkillers if required.
- You will be issued with a ILR identification card.
Going Home Advice
Wound Care
Remove the wound dressing after 48 hours. You MUST keep wound dry for the next 7-10 days to avoid infection. The stitches are dissolvable.
If an infection occurs then the site would appear red, swollen, and painful, be warm & may ooze fluid. If this happens you MUST phone the device clinic.
How to contact us:
Pacemaker/ Device Clinic
Cardiology Department
Russells Hall Hospital
Dudley
DY1 2HQ
Tel: 01384 456111 Ext 2156
Monday- Friday 08.00 – 17:00
Cardiology Day Case Unit
Russells Hall Hospital
Dudley
DY1 2HQ
Tel: 01384 456111 Ext 2573
Wednesday & Thursday 08.00 – 20.00
Cardiology Ward
Russells Hall Hospital
Dudley
DY1 2HQ
Tel: 01384 456111 Ext 2138
Additional information:
British Heart Foundation
Tel: 0808 802 1234
If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on 01384 456111 and ask for the relevant department who issued this leaflet.
If you have any feedback on this patient information leaflet please email dgft.patient.information@nhs.net
This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.