• Reference Number: HEY-619/2020
• Departments: Cardiology
• Last Updated: 24 July 2020

Introduction

This leaflet has been produced to give you general information. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and the healthcare team, 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.

What is a Loop Recorder?

A loop recorder is a small device that is placed under the skin on the chest wall to continuously monitor the heart rate and rhythm. Most devices are approximately 50mm x 8mm x 3mm in size and weigh approximately 5g.

It is fitted just under the skin, usually on the left side of your chest, near to the breast bone and is generally very comfortable.

You will either be given something to carry with you to trigger the device to store information when you have your symptoms or you can download an app if you have a smart phone which does the same thing for certain types of Loop Recorders..

The device has the ability to store the activations you have initiated as well as automatic recordings. All of these recordings will be automatically downloaded wirelessly by using a bedside monitor and are transmitted to a secure server which allows them to be seen by the hospital staff.

Why do I need a loop recorder?

You have probably been troubled by some symptoms and following discussion with your doctor they have advised that a Loop Recorder may be beneficial in trying to help find a possible cause of these. The device will only pick up abnormal heart rates or rhythms so if your symptoms are related to other things, such as low blood pressure then it will not detect these. It cannot treat any issues it detects so if you feel unwell it is important that you still seek medical help in the usual way.

Can there be any complications or risks?

The procedure is very straight forward and carries very little risk but there is a small chance of bleeding and bruising around the insertion site. Very rarely the device may move or break through the skin (extrude)

How do I prepare for the loop recorder?

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.

You will be required to attend the pre-assessment clinic usually between one and four weeks before your EPS/RFA procedure date.

At this appointment you will see a Nurse Practitioner who will take a full medical history, perform a physical examination, explain about the procedure in more detail and address any questions/concerns you may have.

You will  then see a nurse who will perform a baseline nursing assessment. This consists of various questions, such as information about your next of kin, how you usually manage at home, any mobility problems or other issues that we may need to be aware of in order to make your admission as safe and comfortable as possible.

You will then see a clinical support worker who will take swabs for MRSA (a type of bacteria responsible for infection) screening.

Before you leave the hospital an electrocardiograph (ECG) will be performed.

You can eat and drink normally before the procedure and should take a bath or shower the evening before or the morning of the procedure.

What will happen?

You should report to the second reception in Cardiology Outpatient Building at the time stated on your admission letter. Once the receptionist has checked you in will be shown to a bed on the day ward and asked to change into a theatre gown

The nurse who is looking after you for the shift will then check that none of the information you were asked at pre assessment has changed and your blood pressure, temperature and blood oxygen level will be recorded.

You will have a cannula (a small plastic tube) inserted into your hand or arm and a safety check list will be completed. The cannula allows the staff to administer drugs directly into your blood stream and the checklist is to ensure that you are safely transferred into the procedure room .A small area will be shaved if necessary.

The procedure is performed in the ward treatment room by a specially trained cardiac physiologist or nurse. You will be awake for the procedure but the skin will be numbed using a local anaesthetic.

Once you enter the procedure room your information will be checked again using the same checklist as earlier. You will be made comfortable on a trolley, 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 device is to be fitted will be injected with a local anaesthetic to numb the area so the procedure will not be painful.

Once the anaesthetic has taken effect a small incision is made in the skin, this creates a pocket under the skin for the device to sit in.  The device is then inserted into this pocket and the skin is closed, with surgical glue. You may feel some pushing at this point but it should not be painful.

The procedure usually takes about 15 minutes and you may need to take some simple pain relief medication, such as paracetamol, when you get home as it is sometimes a little painful once the anaesthetic has worn off. 

What will happen afterwards?

You should avoid any heavy lifting or manual work for 3 – 4 days after the procedure, to allow time for the wound to settle. You can bathe and shower as normal but should avoid soaking in the bath and actively washing the wound until the glue has disappeared from the skin.

You should avoid chlorinated water such as swimming pools or hot tubs for approximately 2 weeks after the procedure as this can cause issues with the wound healing.

You will be followed up remotely using the home monitoring system so it is a good idea to keep a diary of any symptoms you experience should we detect any automatic recordings that may be significant. The combination of your symptoms and any automatic detections helps us to decide on how to manage your future care.

You will only be permitted to drive after the procedure if your doctor has said it was safe for you to do so prior to the Loop Recorder insertion.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Cardiology Nurse Practitioners (01482) 461647 or the Pacing Clinic (01482) 461535/36/37

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.