Implanted heart loop monitor

[afibtennis]

What are the pros and cons for an implanted heart loop monitor for proximal A-fib? I have not had any episodes for 2 years and always new when I was having one.Trying to assess if it is worthwhile. Electrophysiologist has NOT brought it up. Just curious as to peoples experience.

[BobD Volunteer]

If you know that you have PAF why do you think you need one? These devices are best for people who may have complex arrhythmias which have defied all attempts to diagnose. They are not a treatment tool .merely to assist diagnosis.

[afibtennis in reply to BobD]

A cardiologist recommended this to me so that IF I did have an episode and was NOT aware of it, I would be contacted and then use the anticoangulant (pill in a pocket) I have to reduce the risk of a blood clot.

[BobD Volunteer in reply to afibtennis]

Pill in the pocket anticoagulation is not safe in my view. If your Chadsvasc score is such as you need anticoagulation then you should take it all the time.

OK suppose you did take one when you felt there was an event. How long afterwards would you know as few "reveals" are wireless to hospital. Then how long afterwards to you carry on taking it. Clots can form in the heart and sit there for weeks or even longer.

Far too risky.

[afibtennis]

I know it is tricky. That's why I want to discuss further with my electrophysiologist. My Chad score is 1. I thought if you took something like pradaxa within 2 hours of being in A-fib you would prevent any clot from forming.

[BobD Volunteer]

Maybe but how long to you continue taking it? The jury is still out on that gamble. Other point is how quickly would you be told, even if the reveal was wifi compatible and the hospital will not have somebody sitting watching for it all day everyday.

[JaneFinn]

Hi afibtennis, interesting question!

I’ve never heard of an implanted loop monitor being used other than diagnostically. Sounds like your cardiologist is recommending it as a monitor for immediate treatment needs, specifically anticoagulation - which is a new one on me

In addition to the points made by Bob, I think another con of this approach is that these implanted recorders only have a battery life of around 3 years - I wonder if your cardiologist would just keep replacing it every few years? Also, in my understanding, even the wireless ones only have their info sent overnight? (Though I may be wrong - mine is the antiquated non wireless kind and I have to go in to get my info downloaded every 4 months.)

I think there are plenty of advantages of having an implanted loop recorder - for starters, peace of mind knowing what’s going on with your heart is a huge one! But the usefulness depends upon how appropriately (for your needs) it is set to record. I’ve been very surprised by what it doesn’t pick up on its own accord unless I activate it. I was told that if they set the automatic recording parameters too widely, it means it records too much and the battery is drained faster. Hence I still have numerous short arrhythmias that haven’t been recorded or identified. (Though, again, the newer system probably does catch those things more effectively.)

Another pro is that diagnostically it can help the EP see what has happened with your heart rhythm before you go into AF, and also what happens when you go back into sinus rhythm (if you’re aware of it enough to activate the recorder). These can be useful diagnostically and for developing treatment plans.

I’d be very interested to hear how your conversation with the EP about it all goes - and what you decide

[Daveeba]

Hello Afibtennis. I had my loop recorder fitted a year or so before my ablation because I was having many episodes of AF bth fast and slow but it was PAF and a few months later I had my ablation. That was 6 years ago and seems likely to be there a little longer. I download the loop every 3 months to the hospital and I see the EP next month. Just in time too, I've had some bad episodes as of late. Anyway, take care. Dave