Loop Recorder Implantation

  • Reference Number: HEY-619/2014
  • Departments: Cardiology

Introduction

This leaflet has been produced to give you general information about loop recorder device implantation.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.  If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

What is a reveal device?

A loop recorder is a small device that is placed in the chest to continuously monitor the heart rate and rhythm. It is fitted just below your collar bone and is usually very comfortable. Most reveal devices are approximately 62mm x 19mm x 8mm in size and weigh approximately 15g. You will be given a small hand-held activator to carry with you to trigger the device to store information when you have your symptoms. The device has the ability to store three of these activations. It will also store automatics recordings. All of these recordings will be downloaded at an appointment in the Pacemaker Clinic.

What happens during the procedure?

You will be asked to put on a hospital gown and you will have a small needle (cannula) placed into a vein in the back of your hand or in your arm. You will be given intravenous antibiotics through the cannula before the procedure to reduce the risk of any infection. A small area around the collar bone will be shaved if necessary. The procedure is performed in the Cardiac Catheterisation Laboratory. You will be awake for the procedure.

You will lie on your back in the theatre, your body will be covered with sterile theatre towels and the skin around the neck and shoulder area will be cleaned with a cold antiseptic solution. The area where the reveal device is to be fitted will be injected with a local anesthetic to numb the area so the procedure will not be painful.

Once the anaesthetic has taken effect a small incision (approximately 2cms) is made. A pocket is then made under the skin for the device. The device is then placed into this pocket and the skin is then closed, usually with dissolvable stitches or glue. The procedure usually takes 30-40 minutes.

What happens after the procedure?

When the procedure is over, you will return to the ward area where you will recover for at least 2 hours.

What are the complications and risks?

The risks from having a loop recorder device implanted are small. Bruising around the operation area (device insertion site) is common, but please be assured that this usually resolves within a week or so and is nothing to be concerned about. Rarely, infection around the device can occur; the intravenous antibiotics given prior to the procedure aim to prevent this complication.

How do I prepare for the procedure?

Please read the information leaflet. Share the information it contains with your partner and family (if you wish) so that they can be of help and support. There may be information they need to know, especially if they are taking care of you following this examination.

Pre-assessment

You will be required to attend the pre-assessment clinic prior to your procedure date. At this appointment, a nurse will confirm your personal details and perform a nursing assessment. You will then see a nurse practitioner who will take a full medical history, perform a physical examination and after discussing the procedure with you, will ask you to sign a consent form. You will then see a clinical support worker who will take some blood samples, take some swabs for MRSA (a bacteria responsible for infection) screening and an electrocardiograph (ECG) will be performed.

Medication

Some medications have to be stopped before the procedure. This nurse practitioner at your pre-assessment appointment will tell you if this is necessary for you.

It is very important that you bring all of your current medications or a current prescription with you to any appointment.

If, for any reason you do not attend the pre-admission appointment or if you have any questions about your medication or should you require further advice on the issues contained in this leaflet, please do not hesitate to contact:
Cardiac Nurse Practitioners – (01482) 461647 (Mon-Fri 8am-4pm).
Cardiology 5 Day Ward – (01482) 461518 / 461517 (Mon-Fri).

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.