A big shout out for an ILR - implanted loop recorder ECG

[Chinkoflight]

Some may have seen me get a bit passionate generally in replies to questions about the benefits of having an implanted loop recorder ECG. ( Read on later to see a bit more detail)I had a cryptogenic severe stroke (unexplained) 2 years ago March. 95% recovery following thrombolysing treatment.

Subsequent Holter monitors, echos etc couldn't find a cause. So 12 months ago today,an ILR was implanted. 3 months later Afib was detected leading to a change of medication and a likely explanation for the stroke.

Fast forward to 27th January and I had a no warning syncope event while doing a Saturday Parkrun. Out for about 45 seconds, banged head, body, knees etc. Blue lighted to A&E. The primary concern was the possibility of bleeds (EDOXABAN) so lots of X rays. In a stressed department the pressure was on for a discharge and this happened after 36 hrs when the protocol suggested I should see a cardio. However there was a hint of scepticism, old man running, trips(?) falls and bangs head, knocked out versus my witnessed view old man momentarily dizzy, runs whilst falling, collapses and bangs head.

Very anxious about this on Monday I phoned cardio spoke to the EP technician and asked to check my ILR recording. I marked the event 20 minutes or so after I came round with a little device I carry with me.

Just before Midday I was called back and asked to go to A&E immediately they were expecting me where I will then be admitted to the Cardiology unit!!! Do not drive.

My ILR device had picked up a text book Ventricular Tachycardia event lasting 23 seconds. If I had not had this fitted I'm fairly sure in the context of health pressures I would have been discharged not to be seen again, as old man running, trips falls and knocks himself out. Carry on but pick your feet up!!!

I am still in cardio writing this two weeks later. I will be off tomorrow for a day trip to have a detailed MRI in the regional heart specialist facility!

ILR's are now being regularly offered to people with suspected paroxysmal Afib in order to reduce deaths from strokes by 6500. This was instituted following revised NICE guidance in England with the aim of fitting up to 600000

devices. They aren't fitted for detecting VT so what a bonus. At this stage it's probably chance and unrelated to the stroke event. Running may have been the trigger but was not the cause of the event. New echocardiogram and angiogram show no underlying heart defects and I have an EF of 65%.

If you get offered this device, or think you should be offered this device don't even blink to think about it, say when. In my opinion!

[meadfoot]

Well done for having an ILR. I have been wanting one for several years but my EP is resistant saying they get tons of information most not that useful. Well howcshortsighted and dangerous is that given yourvexperience

So pleased the implantable has done its job for you and wishing you well with the relevant treatment. Thanks for posting your experience.

[Chinkoflight in reply to meadfoot]

Hi See reply below. Your EP is completely wrong. It's transformative from using Holter monitors which are unreliable and truly do require intensive manual examination of all the data. The ILR , mine is a Medtronic LINQ device, does all the analysis using AI and then sends a report when there is a problem. It works to detect paroxysmal events. In continuous or frequent Afib etc that has already been detected it would not be of value.

[meadfoot in reply to Chinkoflight]

I agree totally.

[Sixtyslidogirl]

Thanks for posting this. Sounds like a great idea. It’s not the same but I have PAF and wear a fourth frontier X device when exercising and when asleep which provides a continuous ecg trace. It catches most arythmias, the disadvantage being that you have to identify them yourself (I believe Wellue 24 does a better job). And it is tedious to look at the sleep traces everyday. On the other hand, it helps me identify triggers and patterns I don’t like the look of that I can discuss with my cardiologist.

[quanglewangle]

Hip Hip Hooray for ILR. When they saw the syncope faints verified I got my pacemaker 3 days later.

[Chinkoflight in reply to quanglewangle]

Great news.

[Fblue]

hope you have a full recovery. I have not had an ablation thus far, but my EP said, after an ablation he would want to install the loop recorder before allowing me off anticoagulants to watch if I still go into a fibs. So I know it’s very useful in that case as well.

[Chinkoflight in reply to Fblue]

I agree. Interestingly though, if they fit an ICD for me ( likely) they said they would remove the ILR. They do get data from the ICD so maybe it would be duplication in my case.