Insertable Loop Monitor Implantation

What is it?
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 device is implanted just beneath the skin in the upper chest area
during a single procedure. 

How does it work?
The Insertable Loop Recorder continuously monitors the rate and rhythm of the heart. Heart rhythm information is recorded
during the actual fainting episode and can be played 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
analyzes the stored information and determines 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.

 What should I expect?
Prior to your procedure, we may request tests, such as an electrocardiogram (ECG) and blood tests. We will review all medications
you are taking, and give you any special instructions concerning them. You'll be told 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, you'll be asked not to
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'll be asked to sign a routine consent form. This is a
good time to ask questions or talk about any concerns you may have. 

Before your procedure, an intravenous line (IV) will be inserted in your arm to administer any medications. The area where the
loop monitor will be inserted will be washed with an antiseptic soap and shaved. You'll be covered with sterile drapes. You'll be
awake through the procedure, but will be given a sedative to help you relax and make you drowsy.
The procedure room personnel, who have been trained specifically in the electrical activity of the heart, will be wearing surgical
hats and masks to assure that the environment is kept as clean as possible. Your ECG, heart rate, blood pressure, and oxygen level
will be monitored throughout 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 electro physiologist will make an incision about 2 cm. in length (3/4 of an inch), creating a pocket the same size
and shape as the Insertable Loop Recorder device. 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.
During the procedure 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, you'll be taken to a hospital room or a recovery area. You'll be discharged to home in a few hours. You may
feel some discomfort in the incision area when the local anesthetic wears off.
Before you leave the hospital, you'll be given detailed instructions about caring for your incision site. You'll also be told what signs
and symptoms to report, and you'll be given a follow-up plan. You should arrange ahead of time for someone to drive you home