Is Loop Recorder really needed?

I have a friend who was recently diagnosed with paroxysmal Afib. He's one of the lucky ones in that he doesn't feel it....He's 78 years old and in very good shape. He was also recently switched from aspirin to Eliquis, 5 mg/BID. He knows my experience with Afib, so has been checking in with me to let me know what various doctors are telling him. He's hesitant to get an ablation, so is wanting to know what else he can do. His EP mentioned getting a loop recorder to monitor his Afib, and/or possibly going on an anti-arrhythmic (I was not a fan of that!)

I have had numerous 2 week, 30 day type monitors over the years, but never a loop recorder, which I believe he said would be inserted under his skin and would monitor his Afib for 3 years. Do any of you have experience with this, and if so, what's the purpose of monitoring it like that if he's on Eliquis?

Barb

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tobherd
what's the purpose of monitoring it like that if he's on Eliquis?

Since he's on Eliquis, what I can think of is he in afib for long periods of time with a high (>100 BPM) rate rate. Since he doesn't sense the afib, he might not know. I would think he could get that information from a watch that records heart rate. If he's seeing high rate during times he's not exercising, then that might point to afib. He could also get a sense just by taking his pulse several times a day and seeing what the rate is (& also seeing if the pulse feels like afib). If not, then nothing to worry about.

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tobherd
Do any of you have experience with this, and if so, what's the purpose of monitoring it like that
if he's on Eliquis?

I can think of one reason: if he is considering an ablation it would give his ablation EP detailed information before the ablation and in monitoring after the ablation. I have a pacemaker, which gives my EP similar information, and it has been very helpful throughout the ablation process to know what is going on and how often.

I haven't heard him say anything about an especially high heart rate, but he has had high BP. I guess I'm just wondering why any more info if needed if they already know he has Afib, and he is on Eliquis.....unless they want to be sure his heart rate doesn't go too high, or too low...?

Just knowing he has afib isn't much information. I had afib for years that came on once or twice a year and lasted no more than 6 hours each time. That wasn't worth treating with drugs, much less considering ablation. That's a world of difference from where I ended up 8 years later with afib episodes twice weekly lasting 12+ hours. Although I always had very high heart rates so it was blatantly obvious to me when I was in afib, that's not true for everyone. Many people experience "silent afib" where they go into afib but don't experience symptoms so don't even know they're in afib. It's useful information to an EP to know what your afib burden is without relying on you detecting and reporting it. Loop recorders are useful, safe, and extremely common these days. I don't see any downsides to having one.

Is it’s circuitry sturdy enough to get ECV? An Iwatch is recommended to be removed beforehand. Any limitations for having a loop recorder when one is being ECV regarding joules strength or distance from the pad to the device?

In comparison, a pacemaker is permanent and is ECV friendly. I just never had the pad directly over it during an ECV. They placed it about 1-3” away due to me being petite, but up to 6” is usually recommended I’m told if someone has a regular sized torso.



Edited 3 time(s). Last edit at 07/10/2023 02:38AM by susan.d.

I’ve had Medtronic Linq for 3 years, which has just run out of battery. Along with the device, I also was given a bedside machine, which recorded episodes and sent them onto my EP each night.
Minimum of fuss.

In January, I was diagnosed with Atrial Flutter. I was put on Xarelto blood thinner and Metoprolol to control my heart rate. Worked pretty well for a month or so but my heart rate shot up and had to have Cardioversion. In an effort to get off the Xarelto, I have had an ablation. After 90 days I was taken off the Xarelto and have a Medtronic LINQII monitor with an app on my phone that sends the information to the doctor. I just placed my charger on my nightstand next to me and the phone app does its nightly thing. Only had it for a few weeks but so far seems to work ok.