Loop recorder implantation is a medical procedure that involves the insertion of a small, implantable device beneath the skin on the chest wall, this device, known as an implantable loop recorder (ILR) or insertable cardiac monitor (ICM), plays a crucial role in monitoring and diagnosing various heart rhythm disorders. In this article, we will explore the reasons for performing loop recorder implantation, the necessary preparations before the procedure, what happens during the implantation itself, and the steps to follow after the procedure.

Why Loop Recorder Implantation is Done

Loop recorder implantation is recommended for several reasons

Unexplained Symptoms

It is often performed when patients experience unexplained symptoms such as palpitations, fainting episodes, or unexplained falls, and other diagnostic tests have not provided a clear diagnosis. These symptoms may be indicative of underlying heart rhythm disorders.

Long-Term Monitoring

Unlike standard electrocardiograms (ECGs), which record heart rhythms for only a few seconds, loop recorders can continuously monitor and record heart activity for an extended period, typically up to three years. This extended monitoring is particularly valuable for capturing intermittent or infrequent heart rhythm abnormalities.

Arrhythmia Diagnosis

Loop recorders help healthcare physicians diagnose and characterize various heart rhythm disorders, including atrial fibrillation, bradycardia (slow heart rate), tachycardia (fast heart rate), and other arrhythmias. By recording data over an extended timeframe, these devices offer a comprehensive view of a patient's heart rhythm.

Treatment Planning

Once a diagnosis is established based on the recorded data, loop recorder implantation can guide treatment decisions. Depending on the specific arrhythmia or heart condition identified, patients may receive therapies such as pacemaker implantation, cardiac defibrillators, ablation or medications.

Preparation Before Loop Recorder Implantation

Before undergoing loop recorder implantation, patients should be aware of the following preparation steps

Medical Evaluation

Patients will undergo a thorough medical evaluation, including a review of their medical history and any relevant symptoms.

Medication Review

Patients may need to discuss their current medications with their healthcare physician.


Depending on the specific instructions from the healthcare physician, patients may need to fast for a certain period before the procedure, typically starting from the night before.

During Loop Recorder Implantation

The implantation procedure itself involves the following key steps

Local Anesthesia

Patients are given a local anesthetic to numb the skin at the insertion site, which is usually on the left upper chest.


A small incision, typically about a quarter of an inch in size, is made in the skin at the chosen location.

Device Placement

The implantable loop recorder device is inserted into a small pocket created beneath the skin.


The incision is closed using stitches or surgical glue.

Device Activation

A magnet is passed over the device to activate it, initiating its continuous recording function.

After Loop Recorder Implantation

Following the procedure, patients can expect the following

Same-Day Discharge

In most cases, patients can go home on the same day as the procedure.

Pain Management

Patients may experience mild discomfort or pain at the implantation site, along with some bruising. Over-the-counter pain relievers or medications prescribed by the healthcare physician may be recommended.

Device Instructions

Patients will be instructed on how to use a handheld activator or a smartphone app provided to them. This allows them to trigger the device to record heart activity if they experience symptoms.

Resumption of Normal Activities

Patients can typically resume their regular activities after the procedure, but they should follow any specific guidelines provided by their healthcare physician.


Regular follow-up appointments with the healthcare physician will be scheduled to monitor the recorded data, assess the patient's progress, and adjust treatment plans if necessary.