An insertable cardiac monitor is a small implantable device that continuously monitors heart rhythms and records them automatically or by using a hand-held patient activator. The doctors will implant the device just beneath the skin in the upper chest area during a single procedure.
The Insertable Loop Recorder continuously monitors the rate and rhythm of the heart. Heart rhythm information will record during the actual fainting episode and can play back later for detailed analysis. The Insertable Loop Recorder can continuously record the heart’s rate and rhythm for up to 14 months.
To capture and store the electrocardiogram (ECG) as it occurred at the time of the fainting episode, the patient places a hand-held, pager-sized activator over the Insertable Loop Recorder after waking from an episode, and presses a button. It is important for the patient to keep the activator handy at all times (clipped to the clothes or looped over a belt). Later, a physician will analyze the stored information and determine whether the fainting episode was caused by an abnormal heart rhythm. Once the physician determines this, the device is removed and either treatment is begun or the patient is referred to other specialists.
Prior to your procedure, we may request tests, such as an ECG and blood tests. We will review all medications you are taking, and give you any special instructions concerning them. You’ll receive information on where and when to report for your implantation of a loop monitor (unless you’re in the hospital) and what to do before you arrive. Generally, do not eat or drink anything after midnight the evening before your procedure (except sips of water to swallow your pills).
Just before your procedure, we will discuss your loop monitor insertion — its purpose, benefits, and potential risks. The insertion of a loop monitor is a common, very low-risk surgical procedure with a very small risk of complications. These might include infection, bleeding, and/or bruising. Although the rate of complications is very low, you will need to sign a routine consent form. This is a good time to ask questions or talk about any concerns you may have.
To begin the procedure, staff will insert an intravenous line (IV) in your arm to administer any medications. Staff will wash and shave the area where the loop monitor will be and cover you with sterile drapes. You will be awake through the procedure, but will receive a sedative to help you relax and make you drowsy. The procedure room personnel, who train specifically in the electrical activity of the heart, will wear surgical hats and masks to assure that the environment remains as clean as possible. Staff will monitor your ECG, heart rate, blood pressure, and oxygen level throughout the procedure.
During the procedure, a local anesthetic will be injected under the skin to numb the site where the loop monitor will be implanted in the upper part of the chest. Then, the electrophysiologist will make an incision about 2 cm. in length (3/4 of an inch), creating a pocket the same size and shape as the loop monitor. Once the device is inserted in the pocket, it is programmed to record the ECG during a fainting episode. Then, the incision will be closed with dissolvable stitches and a small bandage applied. You may feel some pushing and tugging on your skin, however you should feel very little, if any, discomfort overall. The procedure usually lasts approximately one and one-half hours.
After the procedure, staff will move you to a hospital room or a recovery area for a few hours before discharging you home. You may feel some discomfort in the incision area when the local anesthetic wears off. Before you leave the hospital, you’ll receive detailed instructions about caring for your incision site. You’ll also know what signs and symptoms to report, along with a follow-up plan. You should arrange ahead of time for someone to drive you home.
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