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Loop Recorder for Monitoring AFib

I live in a suburb of New Orleans and have been writing here off and on for 10 years. I have been married 53 years to the same crazy guy.

The loop recorder is about the size of a quarter.

The loop recorder is about the size of a quarter.

Irregular Heartbeat

I began having AFib episodes seven years ago. Although experiencing an irregular heartbeat is pretty scary stuff, I have had only three episodes in those seven years. I have paroxysmal AFib, which means I have "episodes" of AFib that last for sometimes only a few hours, sometimes for a day or so. Mine have always reversed with medication. Some people have to have their hearts "shocked" to get them to return to normal sinus rhythm. I have not had that happen—yet. Before I go further, let me explain what paroxysmal AFib is. To begin, it is much more common than most people understand. According to the American Heart Association, 2.7 million Americans have AFib. I am far from alone.

Now, what is AFib? According to the American Heart Association, normally, your heart contracts and relaxes to a regular beat. In atrial fibrillation, when you experience an irregular heartbeat, the upper chambers of the heart (the atria) beat irregularly (quiver) instead of beating effectively to move blood into the ventricles. If a clot breaks off, enters the bloodstream and lodges in an artery leading to the brain, a stroke results. About 15–20 percent of people who have strokes have this heart arrhythmia. This clot risk is why patients with this condition are put on blood thinners.

My doctor has allowed me to stay on a low-dose aspirin as a blood thinner because my episodes have been few and far between. Before the one I had in October, I had gone three years without one. I take 25 milligrams of metoprolol twice a day to regulate my pulse rate/heartbeat and help reduce the risk of stroke.

Me!

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Sue

I've inserted the photo because I want this to be a "personal" article for those who may be anticipating having a loop recorder implanted. I'm just a normal 71-year-old woman from Louisiana. I lead a perfectly normal life. We made a long trip this past summer. I walked at least 2 miles a day with no problem. Do not think AFib will change your life forever. You can continue to do the things you like to do as far as exercise goes.

I am fortunate that I have symptomatic AFib. When I say that, I mean I am very aware when my heart goes out of rhythm and into AFib. My heart pounds in an erratic way and feels as though it's beating out of my chest. It's very uncomfortable and scary. However, I am one of the fortunate ones. Many people, my sister included, have AFib that manifests no symptoms. They do not feel anything unusual about their heartbeat. It is particularly dangerous for those who don't realize they have paroxysmal or any other sort of AFib because leaving the heart out of rhythm for 24 hours without being on blood thinners poses a risk of stroke. Many people who have AFib take blood thinners rather than aspirin as I do. The low dose aspirin I take keeps the blood thinned, preventing the formation of clots. My doctor has told me that when I am 75, I will need to begin to take a blood thinner because age increases my risk of stroke.

PA, Physician's Assistant

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The Loop Recorder

After I recently had an episode of AFib, I got a notice to see my arrhythmia doctor. When I attempted to make the appointment, he was booked up, as often happens, so I saw his physician's assistant, who is also personable, capable, etc. We talked for a while and during the discussion, she brought up the implantable loop recorder. I was fascinated with the idea and asked her how involved it was to implant the recorder. She said, "It takes about five minutes. The area on the chest is deadened, then, the doctor makes a small cut with a scalpel and pushes the implant in and you're done."

I was totally sold on the idea. In between episodes of AFib, I have had times when I feel like my heart is skipping beats, beating too rapidly, etc. I liked the idea of being constantly monitored, which this implant would allow. Once it is inserted, the person wearing it keeps a monitor that looks very much like a phone by their bedside. It records data from midnight until 6:00 AM. If there is anything concerning, the techs who monitor the devices will see it during their daily review. If not, the information is reviewed at the end of each month, even if nothing untoward happens during the month.

The PA spoke to my doctor and he was in favor of the monitor. We set up an appointment for the procedure to be done. They told me there would be no anesthesia, although the procedure would be done in a hospital. A nurse would give me shots to deaden the area around where the implant would go. I wasn't worried about it at all, having had a couple of needle biopsies of the breast that were totally painless. I was ready.

Heart Monitor

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The Day of the Procedure

My husband went with me to have the procedure done. They took us back to a small room. My doctor came in and said hi and told us he had another procedure he had to do first, then would get to me. When he was ready, my husband went to the waiting room, and I was taken back to a room, introduced to the two nurses who would be assisting. My chest was scrubbed with antiseptic, then they made a tent of a plastic sheet with which they covered my head. Now I couldn't see. I realized it was to keep me from breathing germs on the site they were going to cut open, but it was disconcerting, nonetheless.

I could hear my doctor's voice as he walked in, and he began to talk to me, which he pretty much continued to do throughout the procedure. I would not say that the procedure was painless. I don't know whether he injected the area to deaden it or one of the nurses did, but it stung and hurt quite a bit. Almost immediately after the shots of lidocaine, I felt tremendous pressure as he pushed the device into the small cut he had made in my chest. I didn't feel the cut, thanks to the lidocaine they injected. The "pushing" of the device was not painful, just a lot of pressure. When I asked if they were through, they said they had to test the device to see if it was recording. It was and thank God for it because I truly didn't want to go through it all again. Let me clarify: I was expecting something akin to the needle biopsy, which was a 1 on the pain scale and I got something closer to a 5. It wasn't terrible. I just wasn't ready for it. I would definitely do it again.

Another thing I appreciate about the implant is that I can travel with it. We went to our cabin in Arkansas recently and it worked fine. It had to search occasionally for a cell tower -- it works off the cell towers -- but it did work. Peace of mind is priceless.

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I went back today for a checkup of the device. The women who run that department told me they had looked at all the information recorded on the loop recorder and it was all normal. There is a small hand-held monitor that accompanies the monitor that sits at my bedside. If I hold the smaller monitor over the implant and push a button, it records whatever is going on at that moment with my heart. They said everything I recorded was normal and not to record anything except if I thought I was in AFib or something else serious. That was when I learned that the "missed heartbeats," rapid heartbeats and breathlessness I experience sometimes are nothing serious.

The implant lasts for three years, then the battery has to be changed. The loop recorder has given me peace of mind. Before I had it, I wore a monitor with leads that I had to replace with fresh ones after my shower every night for a month out of each year. It was annoying and cumbersome and hard to hide. The implant eliminates the need for that monitor. I know that anything not quite right will be picked up when the data is reviewed. I recommend it to anyone who needs monitoring.

As far as discomfort, I truly do not ever feel the implant. I don't even know it's there unless I think of it. That part is perfect. Technology is grand, isn't it? I truly don't understand that much of it, but when I think of my mom complaining of her pounding heart, I wish the technology had existed in 1950.

Ablation Procedure

If medications and cardioversion (shocking of the heart) do not work to keep your AFib under control, your doctor may recommend an ablation procedure. This is usually done if your AFib symptoms are serious enough to keep you from your daily activities. There are two types of ablation procedures, catheter ablation, and surgical ablation. I have never been in a situation to learn more about them, therefore, I won't write about them here. I read somewhere that the people who know little about an actual surgical procedure fare much better than those who "study up" and know everything that's going to happen. I'm going to remember that and steer clear of becoming overeducated, especially since I'm not there yet! Just remember that if you develop arrhythmia (an irregular heartbeat) there are many options open to you. It's not the end of anything, even your peace of mind, unless you allow it to be.

Post Script

Since I wrote this article, I have had two or three more episodes of AFib and my doctor recommended I begin to take Eliquis instead of the low dose aspirin. I've been taking it three years now and don't even think about it except to feel more secure about not having a stroke.

I also made a trip with my husband to Jackson Hole and visited the Teton Mountains and Yellowstone Park. Despite the altitude, I had no problems and had a fabulous time, holding my breath like everyone else at seeing grizzly bears in the wild and reaching the Continental Divide. Great fun! Don't let AFib keep you home.

Two weeks ago, I was notified by my doctor's office that my "battery had died." Made me laugh, but it does necessitate a small procedure to replace it. I will be put to sleep this time, although they put it in with no anesthesia except local, shots. They said it would be similar to what I had with a colonoscopy. They are putting me out because the nurse explained that tissue sometimes grows around the recorder and it can be painful. I'll have it done the 30th of July. Haven't seen my doctor in three years, so will be nice to see him. I always choose his PA because he's usually booked for three months and she's just fine for me. The monitor has given me peace of mind at various times and I recommend getting it. When I go into AFib, I record the episode when it begins and they can monitor it from that point forward when they review the recording. It gives me comfort to have someone acknowledge that I was in AFib and not overreacting or imagining it. It's also comforting to have the doctor check the recording from the monitor once a month to see whether I'm having any AFib I'm not aware of. I'll update again once I have the procedure.

And here's another update, August 11, 2021. Due to COVID, my procedure has been postponed indefinitely.

On Again!

Because of the decreased threat from COVID and the fact that have had three COVID shots, including the booster, my procedure is scheduled for November 10, five days from now. They will remove the old monitor and replace it with a new one with a new battery. I will write about it a day or two afterwards. Wish me luck!

Post-Post Script

The November procedure was canceled because someone dropped the ball and didn't tell me to stop my blood thinners for two days. I'm glad they caught it in time and actually canceled it the day before the procedure was to take place.

We got back from our second trip to Jackson Hole on Sunday, this time mainly to take a winter tour and a sleigh ride in the national elk reserve. I did have some trouble with altitude sickness this time, but it had nothing to do with AFib, just racing heart and exhausted when I moved around. Other than that, I did fine. I had to stop my blood thinners for two days before the procedure, which was done on Tuesday after we got back on Sunday. I was a little leery of the idea as my sister had a stroke after stopping hers for surgery. However, the doctor assured me this is a very noninvasive thing and I went ahead with it. Can't say it was pleasant, but it wasn't awful, either. My doctor is very sweet and the nurses were great. If you have it done, I highly recommend medicine to relax. Even after being given the relaxing meds, I could feel him pulling on the old monitor to get it out and it was pretty gross. Anyway, I survived. My advice is take the drugs if you're having one taken out and replaced. I had a bad episode of nausea and diarrhea through last night and this morning. The nurse and I both think it was the antibiotic they gave me by IV after the procedure. When I take antibiotics by mouth, they make me have heartburn and diarrhea. I'd rather have a day of unpleasantness than an infection so that part is okay too. I'm glad I did it. I have AFib that is definitely symptomatic, but with the monitor the ones watching it can tell if there is any AFib in addition to what I'm feeling and I can send recordings when I do have it so that I know I'm correct and that it is AFib. If you decide to do it, good luck. I'd compare it to having a tooth pulled that is very resistant to the process! Good luck. And for anyone who is interested, I am now 76, 77 in March. Don't let AFib keep you home. Memories of our trips to Jackson Hole will help me manage the long, hot summer here outside New Orleans.

Wonderful Memories! Take the Trip!

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Postscript

Because I've been asked about this, sometimes the loop sets off the scanner at the airport and sometimes not. I've never had problems. If it goes off, I tell them what it is and they let me go.

Small Hiccup

Just because I think it helps to know what's coming with AFib, I had a small hiccup once the new monitor was in. My doctor didn't want to use to same site to implant the new monitor. For whatever reason, the nurses said he always does a new incision. He put it on the side of my left breast. Unfortunately, it moves around and pokes out. It was bothering me a lot at first. I went to see his PA and she assured me it was strictly a surface thing and could do no harm. Once I knew it okay, I stopped noticing and it's fine now. It still pokes me and moves around at night as I I move a lot in my sleep, but it's okay, I don't notice it.

As time goes by with AFib

I keep adding these postscripts because I remember how hungry I was for practical information about AFib. My arrhythmia doctor told me that the episodes of AFib would increase as I get older and they have. I began this never-ending article when I was, I think, 71. I had AFib four times this past year, and for a long period, I went years between episodes. It still reverses with flecainide, usually within a short period of time. I am overweight and have sleep apnea. I can't sleep and wear the C-PAP machine mask, just couldn't do it, so I'm sure that' contributing. Here are some things that have triggered AFib for me and some things that help when I'm having it. It feels like something in my heart slamming around (out of rhythm) in my chest.

Triggers: Sugar or a very large amount of coffee. I limit it to three cups a day and the doctor says that's okay.. A brownie and coffee from Starbucks started it one day last year.

Tylenol 3. I was prescribed this for a neck injury, took it for two days and went into AFib. I think probably any opioid kind of medicines cause it.

Steroids Dexamethasone. I was prescribed this for a persistent rash and started AFib after the first dose.

Overeating is a definite trigger for me.

Overexercising: This is a fine line. I mow the grass but do it in segments now. One day that I did both the front and very large backyard, it did start AFib.

Most of us know not to take decongestants with a D at the end. I simply don't take them at all. It's not worth it.

Things to help handle an episode

Deep breathing helps me. I do it for as long as 30 minutes. A couple of times the episode actually stopped right away when I was doing it.

Try to be alone. My husband means well, but he makes things worse.

Unless your doc tell you otherwise, learn not to go to the ER unless it's absolutely necessary. Unless you are having trouble catching your breath or having chest pain, I recommend staying at home and riding it out unless your doctor tells you otherwise. I used to get frightened and go to the ER. Now I usually just take two flecainide and lie down. Of course, this should be your doctor's call.

I've never had to have the shock thing, so it seems to be working so far. I wish anyone reading this good luck. My husband and I are planning a trip to Santa Fe. Don't let AFib keep you at home. Check out the medical facilities where you're going and just do it. Be sure to take any meds you would need with an episode. Keep altitude in mind when planning your trips. It didn't affect me in Wyoming, but it's an individual thing, I think. Wherever you go, stay well hydrated. Godspeed!




Benefit of the Loop

This article is going to have a million "postscripts" but it would have been help to me to hear someone else's experience when this all started for me, so I'll continue the additions. I mowed the front yard last week. Usually I break it into two parts but I was feeling unusually energetic and did the whole thing. It's a postage-stamp yard like most others and I wasn't worried about it. I mowed it with a self-propelled mower, not a riding one, just a regular lawnmower. I finished, went inside took a shower, and sat down to work. My heart did something weird. At first I actually thought it was a stroke, because it was so intense, then it settled into a rhythm I'm accustomed to, AFib. It was more intense then usual, so I messaged my doctor's office and told them I was sending a transmission of it. The woman who reads the transmissions called me and asked me to send another. She said it was unusually fast, pulse reaching 160. Mine usually stays around 135 these days during an episode. She said the ventricle was trying to keep up with the atrium, in other words, the bottom of the heart was trying to keep up with the top.

I took two flecainide and lay down. It went on for about two hours, then reversed. I do have more AFib as I get older, I'm 76, but I find it reverses sooner, seldom goes all day and night like in the past. The doctor's office called shortly after I spoke to the women in the monitoring lab. She had me send one more transmission, called back and said everything was fine. She said the AFib was intense, but that my heart is okay and nothing to worry about.

I can't even imagine, without the LOOP monitor, all the aggravation this would have caused. I would have gone to the ER because I was so uncomfortable only to find everything was eventually fine. My best advice, get the monitor -- or get a monitor. I know there are others besides the LOOP. The whole idea is to be able to communicate with your doctors and avoid the ER with all it's potential COVID cases and other unpleasant stuff. It gives me peace of mind to know my doctor monitors it once a months and is aware of anything going on at night.

I hope I'm not adding another postscript to this soon! Good luck to everyone.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Questions & Answers

Question: What are the things that bring about AFIB symptoms?

Answer: Physical activity. I mowed my front yard about two months ago. It's small but I usually divide it in half. This time I didn't. I finished, bragged to my husband that I had done the whole yard and no AFib and immediately felt my heart go out of sync. Overeating has caused it for me, lack of sleep, etc. But principally physical exercise.

Question: what are the reasons person gets.AFib episodes?

Answer: The reasons vary. Sometimes they are caused by underlying heart disease. Mine is called paroxysmal Afib. The definition of paroxysmal AFib is spontaneous AFib ending in less than seven days. Mine has never lasted more than 24 hours.

© 2018 Sue Pratt

Comments

Sue Pratt (author) from New Orleans on February 11, 2018:

I wish you well with your next checkup, Elizabeth. It's funny you wrote this comment today as we just arrived at our cabin in another state and my monitor that records data from the implant is sitting on the bedside table at home! Oh, well, surely I'll be fine for 10 days! As far as Verapamil, I've never taken it. Hopefully someone else will chime in. Thanks so much for commenting.

Elizabeth lovic on February 10, 2018:

Thank you for telling us of your experience. My ex boyfriend had the loop recorder, amazing how it works! I went out with him for four years, in all that time he never experienced an episode. I have AFib and to be honest it seems to give me more problems than his heart problems did, Happy for him and wondering what will be suggested at my next check up. Could anyone tell me if they have had to come off Verapamil and are taking something else instead?

Sue Pratt (author) from New Orleans on January 08, 2018:

Thank you, K.S. Lane. I wanted to write something that might make people realize AFib is not the end of life as they know it, the way I thought it was when I was first diagnosed. Thank you for taking time to comment.

K S Lane from Melbourne, Australia on January 08, 2018:

Thanks for detailing your personal experience with such candour. I'm glad the device has given you peace of mind! It truly is amazing what modern technology can achieve.

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