Loop Recorder

Hi,
It has been some time since I last posted. I just finished 1 year since my ablation without any issues and have remained in normal sinus rhythm. I was also participating in a clinical trial and just completed the process. In meeting with my EP, he recommended using a loop recorder that is inserted under the skin in much the same manner as wearing a holter monitor when checking for heart rhythm abnormalities. The "recorder" lasts for approximately 3 years until it needs replacing. The doctor recommended wearing it if I wanted to get off the use of blood thinners. Has anyone had experience with using one of these devices? For me, knowing the recording of my heart 24/7, where I have no sense of control (unlike using a Kardia mobile device), while convenient, seems psychologically like it would wear on me. Plus, the data that is being downloaded monthly with the device, as I was told.
Thank you.
Diana

I've worn one a couple of times and I don't understand the psychological aspect you mention. It's recording your heartbeats, not your conversations. And the data? It's the most boring data in the world. All it outputs is a report giving various measurements like how many PVCs, PACs, runs of arrhythmia, etc. it has detected. That's what your EP will see. I doubt if anyone looks at the raw data.

Mine will be 35 months old when I have my first ablation with Dr Natale in August. I’ve been advised that he will probably replace it at that time. Vs using a Kardia. They will change the monthly reports to be sent to TCA instead of my local EP who currently receives them and who implanted this one.

I have PAF. It has also captured a few very short, slightly over 3 second, Pauses in the past 33 months in addition to 1 tachycardia episode. I don’t think I could have captured a pause with a Kardia for whatever that’s worth. And there is the Red Alert feature where the remote monitoring facility can send to your EP or Cardiologist more urgent captured data. Plus you have the Samsung phone where during an episode you hold it to your heart and then add symptoms if any. I have forgotten to mention it at one mammo And one chest X-ray to the operator and they’re like hey what’s that!!! LOL

Bottom line for me: They said it was up to me and I will do whatever they advise at/during my procedure since the expected lifetime of the battery the first HLM is about to expire.

If you wanted to get off the blood thinners but didn't want the recorder, a question for the EP is what minimum duration of afib are they looking for? For example, if you sampled with a Kardia twice a day (12 hours apart), but didn't see afib, you would know that you didn't have any afib longer than 12 hours. You could have more frequent readings to catch shorter duration afib. Also, devices (watches or fitbits) that track heart rate variability (HRV) and/or heart rate could also be used. Absent exercise, a high heart rate could indicate afib. Higher than normal HRV could mean afib, or a lot of ectopic beats. Seeing these or an abnormally high heart rate during sleep could be a signal to track with a holter and determine if afib is the cause.

My take on this is slightly different from George's. Why would you need a loop recorder to go off a DOAC if you are deemed to have a successful ablation...AT ALL? Either you're free from AF or you aren't. If you're still philosophically and practically at risk of a sudden recurrence, the loop recorder will do nothing for you unless you are taking the DOAC anyway. And if you do need the DOAC to reduce the risk, why have the recorder...AT ALL? Were you not aware of your AF when it happened? If you were asymptomatic, then I could see having both, but not just one of them...if you follow me.

So, I can't see that having the loop recorder is going to measurably reduce your greatest risk from AF, especially if you are currently free of AF. If you are still concerned, and mostly because he/she is, then forget the recorder and just continue with the DOAC! Again, this presupposes you are like most of us who know the sensations of AF.

Well, I can actually see one other caveat, and that would be if your a nocturnal AF person and don't normally awaken because of it, or can't fall asleep well because it commences almost right away when you are recumbent. But generally, for my way of looking at this, the DOAC is probably for life, and that is what my cardiologist suggests. I would not have an implant because of the twin reasons that I wear a smart watch and because historically I know immediately when an attack is about to take place.

Wow am I confused.
I thought the CHADS2 score is what is used to determine anticoagulation not how long you go without AFIB.

I was AFIB free for 2.5 years, was I cured? Got norovirus and AFIB started again.

Whether you had an ablation or not, the probability of going into AFIB on any given day is not zero, no matter how long you are AFIB free. Or are the rules changing?

Thank you for your input. What was presented to me by the EP is either I stay on the blood thinners as I was taking during the time I had Afib or get off from the meds and use the recorder. And, I would agree, that the CHADS2 score puts me in the area where I need to take the meds. The recorder will not prevent me from having a stroke. I am very familiar with my body sensations when experiencing episodes of Afib. And I have a fitness tracker I use that I check if in doubt. Wearing a holter monitor when required, for me, has a psychological component knowing my heart is being monitored 24/7. I realize many of you don't see it that way and I get it. I do appreciate your feedback. It helped me with making a decision going forward. Thanks Again.

Quote
MikeN
Wow am I confused.
I thought the CHADS2 score is what is used to determine anticoagulation not how long you go without AFIB.

You are not confused. Being afib-free only means you can safely stop anticoagulants if you're a CHADS-Vasc 0 or 1. I've been afib-free for 8 years and I have a Watchman device, but I still take 1/2-dose Eliquis because I'm a CHADS-Vasc 3.



Edited 1 time(s). Last edit at 06/28/2025 02:52AM by Carey.

Agreed, the CHA2DS2-VASc score determines all risks and sets a decision to start or to continue coagulation. I was merely going on the more narrow topic of AF. If there are other comorbidities, COPD, diabetes, hypertension, then of course they will factor. You don't need a loop recorder for any of those.

Thanks, Carey. I am a CHADS-Vas 2 and am currently, Afib free, so I take 1/2 of the dose of Xarelto. I saw a post you wrote regarding baby aspirin use vs. blood thinner use if free from Afib. You recommended the blood thinner (1/2 tablet) over the baby aspirin due to the stomach upset of the aspirin. The EP I saw for the ablation and follow-up stated the baby aspirin would not be effective for someone to take if the patient had Afib previously and strongly recommended the blood thinner due to its ability to prevent blood clots leading to stroke.

Yeah, aspirin just isn't a good choice for most people. It has a higher bleed risk and is less effective at preventing the kind of clots that afib produces.

And since you're female, you can consider your CHADS-Vasc score to be 1 unless you're over 75. The point for being female is no longer counted for women under that age.

Thanks, Carey. You are on top of it and I appreciate the information. Now that I am a CHADS-1 score (under age 75), taking 1/2 dose of Xarelto, and not experiencing any Afib, the issue of getting a loop recorder inserted for tracking purposes remains a question at this point for me. In other words, I am still taking Xarelto, while a lower dose, and getting the loop recorder would allow for me to get off the meds. This was a question I had and unfortunately, my doctor's staff was not clear about that when I asked after I saw the doctor. Thanks, again, for clarifying for me.

Diana