Implantable loop recorder (implantable cardiac monitor)

The implantable loop recorder, or implantable cardiac monitor, is a miniature electrocardiogram recorder about the size of a small USB stick. Placed just under the skin in front of the heart, it monitors the heart rhythm continuously for about 2 to 3 years, depending on the model. It automatically records rhythm abnormalities and can also be triggered by the patient, using a small activator, at the time of a symptom. Insertion is a quick and simple procedure: under local anaesthesia, the doctor makes a small incision of about one centimetre on the left side of the chest and slides the device under the skin. The small wound is closed with a stitch or skin glue. No lead is placed in the heart. Data are often transmitted remotely, from home, to the cardiology team. It is offered when rare symptoms, such as fainting or occasional palpitations, could not be explained by the usual tests: electrocardiogram, 24- to 48-hour Holter monitoring, echocardiography. It also helps to look for silent atrial fibrillation after a stroke with no cause found. When a rhythm disorder is recorded, the appropriate treatment can be offered: pacemaker, ablation or anticoagulant treatment. At Clinique Pasteur Tunis, insertion is performed by the electrophysiology team, and recordings are analysed during follow-up in clinic.