Loop Recorder

[shayden]

I was hoping you all can help me as you normally do. I am having a "loop recorder" implanted on Monday and I am having a hard time getting over my fears. I think it is simply because I do not know what is going to happen. Have any of you had this done? Could you please descibe the details from the time you arrive at the hospital?

Thanks in advance for your help!

Susan

[Dawg Tired]

I haven't had a loop recorder but I think it is like having a pacemaker put in.

[BuddyLeesWife]

My brother-in-law had a loop recorder implanted and then several months later had it removed. I only remember that he had no problems with the outpatient procedures and I don't recall any complaints about the device while installed. They made a "pocket" under the skin where and device is inserted and in the event that you move forward and receive a pacemaker this same space would be used for it. For him, the loop recorder proved that a pacemaker would not help his syncope.

I'm sorry I don't know more of the procedural details but I wanted to let you know that he did not experience any difficulties. On his recent trip to Mayo, the cardiologists spoke highly of the loop recorder and told him that they were impressed that his local Drs had ordered the implant.

I just found the procedure description from the Reveal monitor my brother-in-law had implanted - hope this sets your mind at ease:

The Procedure

How is the Reveal? Insertable Loop Recorder implanted?

Implanting the Reveal Insertable Loop Recorder takes about 15 to 20 minutes and can be done under a local anesthetic. The physician makes an incision about 2 cm. in length (3/4 of an inch), creating a pocket the same size and shape as the Reveal Insertable Loop Recorder device. Once the device is inserted in the pocket, it is programmed to record the ECG during a fainting episode. No overnight hospital stay is required.

When heart activity is recorded during an actual fainting spell, and the physician is satisfied that heart rhythm-related causes can be ruled in or out, the device is removed.

Is the implant procedure painful?

The implant procedure is relatively painless. Local anesthesia is used and the incision created is quite small - about 2 cm. (3/4 of an inch) in length.

What are the risks of the Reveal Insertable Loop Recorder implantation surgery?

Risks associated with the Reveal Insertable Loop Recorder implantation surgery are minor and rare. They include infection at the implant site and reactions to local anesthesia. These are risks common to all forms of minor surgery.

Will the implant affect my physical appearance?

The implant is visible as a slightly elevated area on the skin at the implant site.

How long will I have to have the Reveal? Insertable Loop Recorder?

Generally, the Reveal Insertable Loop Recorder will remain in place until it records an episode of syncope to the physician's satisfaction, that is, until the physician can rule in or rule out an abnormal heart rhythm based on data from the Reveal Insertable Loop Recorder. The battery life of the Reveal Insertable Loop Recorder is about 14 months. If a satisfactory diagnosis has still not been made after 14 months, the physician will decide what to do next.

http://www.medtronic.com/servlet/ContentSe...t_art_procedure

[Mary]

Hi,

I had a loop recorder for a month but it wasn't an implant. I have never heard of that. Mine was external and caught my heart rythm when I pushed a button. It recorded three times and then I had to call for a download. Thinking... since you experience syncope you would be unable to push the record button... ding! ding! on me. I would say the insertion is similar to a pacemaker and I have heard they are relatively painless. Good luck. Report back after the insertion. Mary

[shayden]

Thank you all so much with getting me through this procedure. The procedure went fairly well...I was so drugged...I can't remember a thing which makes me very happy. However, around the insertion site, I am extremely bruised, swollen, and in a lot of pain.

Here is the problem....I had the loop recorder implanted this past Monday (5 days ago)...I have already passed out 19 times since then and they are coming up with nothing. They are telling me that my pulse and blood pressure are staying within normal limits. How can this be? Needless to say...my cardiologist is now looking at me as if I have a mental problem and I know that my head hitting the floor, wall, staircase, or anything else...is not part of my imagination.

To make things even worse...they are thinking that Dr.Grubb was wrong in his diagnosis and that I do not have POTS at all. I'm not sure why this device is not picking anything up but this is what I do know:

I failed the tilt-test within 2 minutes of being stood up and without being given the isoprol.

When I wore the holter monitor, I was taching above 220 beats per minute.

I have almost every single symptom of POTS.

Since I have taken the above listed test, plus many others that I failed drastically, the only thing that has changed is the amount of medicine I am taking. I asked if the medicine could be covering up the disease and they said NO.

Oh...and one other thing....when the surgeon (which is not my Cardiologist) was rolling me back to recovery after implanting the monitor, he stated that my pulse got way too low in his presence (he said it was in the 30's) and that he thought a pacemaker would help! I asked my Cardiologist about this and he just blows me off.

Any Suggestions???

Thanks!

Susan

[blackwolf]

Dear Susan,

I'm sorry you are having so much trouble. On your site, if you can, try cool packs alternated with warm packs.

As to "hitting" stuff, been there done that.

And as to "normal", that is their idea of most people's normal, not really ours. My "normal" is not the normal of others, I get close to blacking out with only small drops on blood pressure as mine runs low to begin with. Fortunately, my cardio seems to understand this. Mabey consider getting copies of your records and having them evaluated by a second doc or even sent to Dr Grubb.

My best wishes in getting the help you need.

Blackwolf

[corina]

Hi Susan,

I'm sorry you are going through all this. I really can't understand why doctors react this way. Everybody can understand your fainting isn't a mental problem, you wouldn't hurt yourself this way it's just something that happens. I think you shouldn't doubt dr Grubbs diagnosis but hold on to that and find yourself a new cardio (if you think you need one). I'm seeing my neuro every 4 weeks at the moment and my cardio only twice a year since my hr is under control by using betablockers. Maybe you can ask dr Grubbs office if they now a cardio who is known with dysautonomia in your neighbourhood. Don't let your present cardio treat you like this, just try and find some doctor who cares. Wish you all the best.

Corina

[Ernie]

Hi Susan,

I had the same situation happened to me not long ago. I had to see the EP to confirm that it is not in my head.

What were your HR and BP supine before TTT and at syncope.

When the doctor said your HR and BP where normal when you passed out, do you know the numbers?

Ernie

[shayden]

Hi All,

Thank you so much for all of your support. I'll tell you...if I wasn't crazy before this whole ordeal...I am now and it's because of the Doctor's.

Corina...Sad thing is that Dr.Grubb referred me to this Cardio because he is local for me and knows a lot about POTS. Dr.Grubb said I needed constant care and since I do not do well on car rides...this would be my best option and then to touch base with Grubb twice a year. The new Cardio is now telling me that he only wants to see me twice a year. It's a never ending battle that I am sure we all understand.

Ernie: I can't remember exact numbers from the tilt (lack of oxy to the brain ) but it was pretty close to this:

Pulse laying flat: 62

BP laying flay: 90/60

Pulse at Syncope: 190

BP at syncope: 90/60 (remained pretty constant)

Pulse awake but prior to recovery: 31

BP awake but prior to recovery: 160/120

According to the loop recorder my pulse is going between 120 & 130 at syncope and they don't tell me the BP. I think they are more or less looking straight for the "Tachycardia" part of POTS.

Does any of this ring a bell? The pulses I know are correct because they scared the heck out of me but the BP's could be a little off.

Thanks!

Susan

[Ernie]

Hi Susan,

Your vitals are similar to mine when I faint and the doctors tell me I am pretending to faint. The doctors believe this because we have no drop in BP during the episode. In your case and mine what they have to look at is the HR which is sky high. Dr Grubb explained to me that I don't pretent fainting and that it is real syncope. He said that our body can maintain a constant BP but we faint because of the blood pooling in the legs. After a few minutes we don't have enough blood to the brain and we pass out. When you have a high BP at recovery this shows that your body is readjusting from the faint. If it was all in your mind your heart would not go to 190 before fainting and your BP would not increase after syncope when laid flat.

Have you had your catecholamines (adrenaline, norepinephrine, dopamine)measured? That could help you prove that it is not in your head. This is the test that proves I have organic reason to faint. Really important document when I meet a new doctor or go to the ER.

Dr G told me that we are hard cases to diagnose because on top of not teaching dysautonomia in med school they don't teach that it is possible to faint with a high HR and constant BP. Even regular cardiologist are not aware of that.

If your HR is 120-130 you have tachycardia.

Believe my experience, it is not in your mind. You are really fainting.

Ernie

[lisamac]

hello , i was just wondering how they are getting your b/p from the loop recorder?my son had one implanted about 4 years ago for breatholding spells. every time he had a spell we pushed a button and it would record his heart rate .it would record 15 seconds befor the spell and 45 seconds during and after ward . i should add he did pass out anywhere for 30 sec to 1min with each spell . we found out after they down load the machine his heart was pausing 7 to 15 sec each spell.shortly after he had a pacemaker implanted . i was just wonder if they can record the b/p since we are having a hard time recording it with the 24 hour b/p test .they always seem to give him test on good days !

lisa

[shayden]

Hi Lisa,

The Reveal Loop Recorder by Medtronic is the device that I have implanted and yes, it does give them my Blood pressure. What it does is takes a complete EKG reading which gives them everything they need to know.

Isn't it nice how your body works? I had the same problem with getting an accurate reading on my blood pressure and I wanted to feel free to take it when I knew I felt bad. Since I faint, that made this a little unrealistic. There was no way that I could put the cuff on, position it correctly, and then hit the button to get my BP. So my suggestion is: Buy a wrist BP Monitor. It will measure systolic blood pressure, diastolic blood pressure, mean arterial pressure, and pulse. It also can save upto 30 readings with date and time. AWESOME for simply taking it in to the Doctor's. These are great and they can be purchased for <$50.

Hope this helps! Please take care!

Susan