What is an implantable loop recorder?
An implantable loop recorder is a small device, about the size of a memory stick, which is implanted under the skin on your chest. It records the electrical signals in your heart so that when the recording is downloaded, your doctor will be able to see how your heart has been working.
Why do I need one?
Your doctor will have suggested an implantable loop recorder because you have had some unexplained fainting. This may be due to abnormal heart rhythms. Other tests such as a 24-hour electrocardiogram (ECG) are not usually suitable as you might not
faint during the 24-hour test.
The good thing about an implantable loop recorder is that it records how your heart is working over a period of months, so should record what happens when you next faint.
The loop recorder can stay in place for up to three years. Once the doctors know what is causing your fainting, they may take out the loop recorder.
What happens when I have an implantable loop recorder fitted?
You will have your loop recorder fitted in a small operation while you are under general anaesthetic. Your doctor will explain all about the operation and ask you and your parents to sign a form giving permission for the operation to happen.
While you’re under the anaesthetic, the doctor will put the recorder under the skin on your chest and check that it is working properly.
What happens afterwards?
You’ll start to wake up in the recovery room a short time after the operation. Your mum or dad can be there if you want. Once you’re a bit awake, you’ll come back to the ward to wake up fully.
The operation site will be closed with stitches under the skin and covered with a small dressing. Your chest might feel sore from the operation, but the nurses will give you medicine to get rid of any pain.
You will be able to go home when the doctor is happy that your recorder is working correctly and you are starting to feel better. Most young people go home the same day.
Your chest may still feel a bit sore when you get home, but this goes away in a few days. If it hurts, you can take pain medicine containing paracetamol, but don’t take any containing ibuprofen or aspirin.
The operation site will be swollen and a bit red and it might also be bruised. Gradually, this will go down over the next three or four weeks. Once the swelling has improved, you might be able to feel or see the outline of your recorder, but this is normal. Because
you know it is there, you might feel or see it more than other people, who probably won’t even notice.
If the dressing hasn’t been taken off in hospital, remove it when you get home. You can have a shallow bath two days after your operation, but try not to get your operation site wet. This could soften the scabs so they fall off too early. The steri-strips® will start to come off in a couple of days. If any are still stuck a week after the operation, you can peel them off gently. You can go back to having a normal bath or shower a week afterwards if the scar has healed.
The scar will get less red over the next few months, and eventually fade to a white line. It can help to gently massage some cream, such as Nivea® or E45® into the scar to make it less noticeable. You can start to do this when the scar has completely healed.
Looking after your operation site
- Change your dressing every day
- Keep a dressing over the operation site for the first few days
- If it has healed well and you feel comfortable, take the dressing off
- If it rubs on your clothes, you might want to keep the dressing on for a week or so
- Check your operation site everyday
- Does it look red?
- Does it look angry and inflamed?
- Is it open?
- Is it oozing, yellow or green?
- If you answer ‘yes’ to any of these questions, visit your family doctor (GP) to have it checked.
- Telephone your clinical nurse specialist to let us know how you are doing. Out of hours, you can call Bear Ward.
- Remember that your recorder site is slightly swollen and the scar is new – both will look better in a week.
- If your operation site becomes raised and painful, telephone your family doctor and contact your clinical nurse specialist to let us know.
Your identification (ID) card
- Always carry your ID card with you
- Always have your patient activator with you
- Photocopy it and keep a copy in your bag and at home, school and in your parents’ car
- Try not to get your operation site wet for the first week after the operation
- Do not wash the area in the first week
- Do not have a shower – have a shallow bath instead
- Wash your hair over the sink for the first week
- Once it has healed, you can wash your operation site gently with water, but pat it dry rather than rubbing it.
Visits to the doctor and dentist
- Remember to tell your doctor and dentist that you have loop recorder each time you visit.
- If you are having any dental work done you will need antibiotics just in case.
- Check that you have your dental card before you leave hospital.
- You will also need antibiotics if you have any operation
- Do not keep your mobile phone in your breast pocket or bag shoulder strap
- Metal detectors are safe but walk through them quickly
- Try to avoid being hit in the chest. It should not damage your loop recorder but it could be uncomfortable. Telephone your clinical nurse specialist if it happens.
What to do if you think you have had a faint
It’s important to download your recorder soon after having a faint. The recorder can only hold a certain amount of information. When it’s full, it goes back to the beginning and overwrites the previously recorded information. You can have the download at GOSH or we can make arrangements with your local hospital.