Cardiac Monitor Implantation(ILR)

WHAT IS CARDIAC MONITOR IMPLANTATION?

Cardiac monitor implantation (also known as insertable loop monitor implantation) is a heart recording device. 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.

HOW DOES CARDIAC MONITOR IMPLANTATION WORK?

The Insertable Loop Recorder (ILR) continuously monitors the rate and rhythm of the heart. The Insertable Loop Recorder can continuously record the heart’s rate and rhythm for up to several years, based on how long the device's battery last.

Monthly downloads of rewarded arrhythmias are sent to provide through the remote system associated with your implanted recorder. You should report any symptomatic episodes to your physician's office.

WHAT SHOULD I EXPECT?

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 you may 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 physician 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. 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 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 are discharged, 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.