loop recorderAn implantable loop recorder (ILR), also known as an insertable cardiac monitor, is a small device about the size of a pack of chewing gum or USB memory stick that is implanted just under the skin of the chest to record the heart's electrical activity. The ILR monitors the electrical activity of the heart, continuously storing information in its circular memory (the "loop" of the name) as electrocardiograms (ECGs). Abnormal activity such as arrhythmia (irregular heartbeats) is recorded by "freezing" a segment of the memory for later review. Recording can be activated in two ways. First, recording may be activated automatically according to heart rate ranges previously defined and set in the ILR by the physician. If the heart rate drops below or rises above the set rates, the ILR will record without the patient’s knowledge. The second way the ILR records is through a hand-held "patient activator" whereby the patient triggers a recording by pushing a button when they notice symptoms such as skipped beats, lightheadedness or dizziness. The ILR records by "freezing" the electrical information preceding, during and after the symptoms in the form of an electrocardiogram.

download reviewThe physician can download and review the recorded events during an office visit using a special programmer, which looks like a laptop computer. The ILR is a useful diagnostic tool when patients experience symptoms such as syncope (fainting), seizures, recurrent palpitations, lightheadedness, or dizziness regularly but not often enough to be captured by a 24-hour or 30-day external monitor.

Because of the ILR's long battery life (2 to 3 years), the heart can be monitored for an extended period.