Implantable Loop Recorder (ILR) Implant

What is an implantable loop recorder (ILR)?

An implantable loop recorder (ILR) is a small slim device that records your heart’s electrical activity. The loop recorder device is placed under the skin in your left upper chest area. This is useful if simple tests like an ECG have been unable to determine the cause of your symptoms.

Why do I need an ILR?

You may have experienced some or all of these symptoms with an undetermined cause:

• Palpitations

• Dizzy spells

• Blackouts.

The benefit of having an implantable loop recorder is that it constantly monitors your heart activity, unlike an ECG or 24 hour ECG monitor, making it more likely to identify a cause of your symptoms. The battery can last up to three years at which point you may wish to have the ILR removed, or it can be left in place.

How does an ILR work?

An ILR works together with a small hand-held ‘activator’. The activator is used to record information from the ILR. When you experience symptoms, place the activator over your ILR and press a button to start the recording. Your ILR will record your heart’s activity. This information is stored for your doctor or cardiac physiologist to look at. Whilst you should use your activator to record information when you experience symptoms, it is important to note that the ILR records automatically anything outside of ‘normal’ parameters. We ask patients to use their activator when they have symptoms to be able to see if there is a correlation between symptoms and what is happening to the heart. If you are concerned about any of your symptoms, or you have had to activate the device, please inform the Cath Lab Reception (01305255288). It’s important to use the activator whenever you have symptoms so that the medical staff can see what’s happening to your heart rhythm when you feel unwell.

What to expect before your procedure?

Before you have received a date and time for your procedure, you will be asked to attend a pre-assessment clinic. At this appointment a nurse will take a medical history from yourself, carry out blood tests and blood pressure checks. You will also be given more details about the procedure, including preparation, medication changes and aftercare.

What happens on the day the implantable loop recorder is to be inserted?

The procedure will take place within the Cardiac Catheterisation Lab by one of our specially trained nurses/cardiac practitioners, with the date and time confirmed in writing before the procedural day. As the procedure is undertaken with local anaesthetic you will be able to eat and drink up until the time of your procedure. On arrival to the cardiac catheterisation lab, staff will complete appropriate paperwork and ensure you are fit for the procedure. Once this has been confirmed you will wait for your procedure in our day ward. When it is time for the procedure you will be taken into the Lab and the skin will be cleaned with a chlorhexidine solution. Local anaesthetic will be injected under the skin and a small incision (approximately one centimetre) will be made. The device will be inserted under the skin and the wound will be closed with a dissolvable stitch with a transparent dressing placed over the top of the wound for protection (this can be removed seven days post procedure at home by yourself or family member). It is important to note that you will have a scar at the site of the implant (the practitioner performing the procedure will aim to minimize this).

What happens after the procedure?

Following the procedure, you will be monitored by the Cath Lab Team and regular observations will be taken until you are ready to be discharged. You will be given something to eat and drink. Your recovery is likely to be about an hour. Prior to going home, a cardiac physiologist will come and speak to you about your device and how to activate it if you experience any symptoms. You may also be given a follow up appointment for approximately four to six weeks after the procedure where your device will be analysed and further information such as your home monitoring device and further follow up appointments will be explained. This may well be arranged remotely to avoid attending hospital. If this is an option for you the cardiology team will issue you with the equipment to do this.

There are no restrictions to arm movement post procedure allowing you to continue your normal daily activities. It has been noted that seatbelts and bra straps may rub over the wound site, with some patients placing something soft under there seat belt or wearing a wireless bra to offer comfort.

How will I feel after the procedure?

Most patients will feel well after the procedure. There may be some discomfort from your wound site once the local anaesthetic has worn off; you will be offered pain relieving medication in recovery. You can speak to your team to discuss what medication you can take at home.

Guidance following discharge after your procedure

After your procedure you will be given discharge information regarding post operative care and who to contact if you have further concerns.

Regarding returning to work, there are no guidelines on when you can return as this is at the patients own discrepancy. However, we would normally expect patients to be able to return to their normal daily activities after 48hours.

Driving

Whilst you do not need to inform the DVLA of your loop recorder implant, the DVLA states that you can not drive if you have been suffering pre-syncope (feeling faint) or syncopal episodes (where you have fainted) You can find the latest guidance from: https://www.gov.uk/blackouts-and-driving

Contact numbers

We hope that you have found this information useful. If you have any questions or are worried about anything, please contact the Cardiology Day Ward on 01305 254990, Monday to Friday between 8am and 6pm.

About this leaflet

Author: Kerry Clark, Cardiac Catheter Lab Sister
Written: October 2024
Approved: October 2025
Review date: October 2028
Edition: v1

If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk