Implantable Loop Recorder (ILR) Removal

Implantable Loop Recorder (ILR) Removal

It has been recommended that you have your ILR removed.

Before your appointment
Please continue all medication including the morning of the procedure and including most blood thinners (aspirin, clopidogrel, warfarin, edoxaban, rivaroxaban, apixaban, dabigatran). If you are on two blood thinners, please call our secretary to let us know and we can advise you of any instructions. If you are on warfarin we ask for you to arrange an INR blood test at your usual INR service, the day before and if it is above your usual range to please call our secretary to let us know on 01905 733560.

We kindly ask men to shave their whole upper chest to ensure the dressing will stick after the procedure.

If you have any equipment such as home monitoring that is kept by your bedside and/or an ILR activator or handset, please bring this with you on the day (or return to your usual Clinical Investigations department following your procedure).

What does the procedure involve?
Similar to the insertion we will require to do some patient safety checklist’s first. We will kindly ask you to remove any upper body clothing including your bra if applicable. The staff member will scrub clean then proceed to cleaning your chest. Once this is dry you will be covered with a sterile drape and you will not see the procedure taking place. We kindly ask you to not lift your hands at any stage as this may impact the sterility of the area. Once the drapes are in place we administer local anaesthetic via a needle which can sting a little. Once this is numb a small incision is made and the implant is removed. Pressure is applied to the area and the wound is usually closed with glue, steri-strips or a suture. A sterile dressing is then applied. You will be given some wound care information on the day before you go home. You are in the room for around 30 minutes.

Are there any risks?
You will be left with a small scar which can often be a slightly different place to your original scar as the monitor may have moved slightly. Bruising is expected especially if you are on blood thinners. There is a small risk of infection which could require oral antibiotics if this occurred but this is very rare and is more of a risk when we implant an ILR/leave an object in your body. Extremely rarely but occasionally we are unable to remove it on the day if it is tricky to remove and we would have to relist you for a second attempt. You will be asked to sign a consent form on the day of the procedure.

Do I need to have the ILR removed?
The manufacturer advises that we remove a device with a depleted battery and therefore we recommend that you do have it removed either because you have had treatment e.g., you now have a pacemaker and it is no longer required or because of the battery has depleted as expected. There are some situations where we might leave the ILR in place e.g., if by attending an appointment it would cause distress such as you have dementia or are having palliative treatment.

Do I need to come back?
We do not routinely use sutures for this procedure. If we did we would inform you of returning for suture removal. If your cardiologist has arranged a follow-up appointment you would get that in due course in the post.

Is there any aftercare advice?
We advise that you keep the area dry and peel the dressing off yourself on day 5. We advise avoiding intense exercise afterwards that might lead to sweating as this may make the dressing loose.

Will I be having another monitor fitted?
Not usually. It is very rare that this is required as usually we have captured your symptoms during the 2-3years of battery life. In addition, it is very reassuring if you have had 2-3years of monitoring without any recordings that require treatment.

Can I drive home?
If somebody can come with you that would be ideal but we understand that is not always possible. If you are able to drive (no DVLA restrictions) and if you feel well then you can drive home.

I have some questions or concerns…
You will be assessed on the day and the staff member undertaking the procedure will go through the procedure with you more and will be able to answer your questions for you.

If you would like to contact the arrhythmia nurses before the day or you have concerns regarding the wound site after the procedure please contact us on wah-tr.arrhythmianurses@nhs.net or 01905 760868.

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PALS@nhs.net
Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.
If you are unable to understand this leaflet, please communicate with a member of staff.

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