Aa
Impantable loop recorder or 30 day event monitor
Hi Everyone! I’m female, about 120 lbs, 5.4” tall. I’ve had Syncope and pre-syncope since my early 20’s and I’m 35 yrs old now. I’ve had 4-5 of these/year but this year I’ve already had 4 pre-syncopes and one full blown Syncope. During these episodes I have: Extreme nausea, palpitations, ringing/ buzz like sound in my ears and then no sound at all, feel hot and sweaty and then cold after it passes,etc..I usually know I’m going to faint because of these symptoms but I have also fainted sometimes with no previous warning or presyncope.
I’ve also had 2 episodes of very severe palpitations which lasted for 15-20 min just after I had started mild exercise ( Felt as if my heart was in my throat). I have never taken this very seriously until recently because I’ve been diagnosed with Fibromyalgia for pain in my back and arms and I started swimming as recommended by my Rheumatologist but now I’m scared to get into the pool.
On a daily basis, I feel extremely fatigued, dizzy, dis-oriented, sometimes short of breath after even slight activity. I have been recording my vitals recently. I have low normal BP of 90-100/60-70, Heart rate while sitting is in 80s and on standing is from upper 90s to sometimes in 120s. My Cardiologist said that I might have Neuro=cardiogenic Syncope but I had a negative tilt-table test result and normal Echo and Stress tests. So, now he is suggesting an implantable loop recorder since my syncope is so infrequent but I got scared and asked for a 30 day event monitor instead. He has also referred me to a EP Cardiologist.
Now, I’m having second thoughts and thinking of getting the Implantable loop recorder instead of a 30 day event monitor as I’m really desperate to find out what is wrong with me and just want to have a normal life and not worry constantly about fainting as I live alone. I’m really confused and would highly appreciate any input/suggestions on where to go from here.
I’ve also had 2 episodes of very severe palpitations which lasted for 15-20 min just after I had started mild exercise ( Felt as if my heart was in my throat). I have never taken this very seriously until recently because I’ve been diagnosed with Fibromyalgia for pain in my back and arms and I started swimming as recommended by my Rheumatologist but now I’m scared to get into the pool.
On a daily basis, I feel extremely fatigued, dizzy, dis-oriented, sometimes short of breath after even slight activity. I have been recording my vitals recently. I have low normal BP of 90-100/60-70, Heart rate while sitting is in 80s and on standing is from upper 90s to sometimes in 120s. My Cardiologist said that I might have Neuro=cardiogenic Syncope but I had a negative tilt-table test result and normal Echo and Stress tests. So, now he is suggesting an implantable loop recorder since my syncope is so infrequent but I got scared and asked for a 30 day event monitor instead. He has also referred me to a EP Cardiologist.
Now, I’m having second thoughts and thinking of getting the Implantable loop recorder instead of a 30 day event monitor as I’m really desperate to find out what is wrong with me and just want to have a normal life and not worry constantly about fainting as I live alone. I’m really confused and would highly appreciate any input/suggestions on where to go from here.
Best Answer
It sure sounds like you have found a good EP who is going to work to figure this all out. I wouldn't doubt that the stress you have been under about this has ramped up your symptoms. I was getting episodes of tachycardia once every couple of weeks until the week before my ablation when I had 7 in the one week and a number of them lasted a few hours a piece. I was extremely stressed about doing the ablation so the extra adrenaline is probably setting you off a bit more than normal. I think once you get yourself looked at and have a game plan things will settle down and hopefully get fixed. Best of luck and keep us posted on how it is all going.
Thank you for the wonderful advice! Yes, I see what you mean:).
I have been thinking the same thing..what if it happens during swimming ( it's something I love and have to do for Fibro). I just want some peace of mind and really take care of this as it has been going on for too long and has come to a point where I just want to know what's causing all this and get it treated. Will see what the EP says next week but want to be ready with an answer by then if he says I should get the ILR.
Michelle, I was curious if you have any arrythmias or any other cardiacrelated issues other than the low BP because your symptoms seem to be similar to mine. Thanks!
I have been thinking the same thing..what if it happens during swimming ( it's something I love and have to do for Fibro). I just want some peace of mind and really take care of this as it has been going on for too long and has come to a point where I just want to know what's causing all this and get it treated. Will see what the EP says next week but want to be ready with an answer by then if he says I should get the ILR.
Michelle, I was curious if you have any arrythmias or any other cardiacrelated issues other than the low BP because your symptoms seem to be similar to mine. Thanks!
There was a success story on here for an implantable loop recorder (ILR). Someone was able to catch the event, which like you was syncope related, and they were offered an ablation procedure as a result. The results of the ablation were positive.
My own humble opinion was against IRLs up to that point.
With a holter, you run the very remote possibility of the event occurring when you're changing leads or just not wearing the device for some reason. I didn't wear mine in the shower, for instance.
I've seen people report discomfort with ILRs at first. Others say it was fine.
I can only relay what I've heard and read. I don't have first hand experience with one.
Another piece of advice I always offer is to think the test through. OK so you manage to catch an event on the recorder, now what? Sometimes working the problem through from the other end can lead to other conclusions.
In this case the "now what" would probably be an ablation if they can narrow down what part of your heart is causing the issue.
My own humble opinion was against IRLs up to that point.
With a holter, you run the very remote possibility of the event occurring when you're changing leads or just not wearing the device for some reason. I didn't wear mine in the shower, for instance.
I've seen people report discomfort with ILRs at first. Others say it was fine.
I can only relay what I've heard and read. I don't have first hand experience with one.
Another piece of advice I always offer is to think the test through. OK so you manage to catch an event on the recorder, now what? Sometimes working the problem through from the other end can lead to other conclusions.
In this case the "now what" would probably be an ablation if they can narrow down what part of your heart is causing the issue.
Thanks Michelle, for the encouraging words. Haha..yes! I know what you mean..feeling dizzy, slight palps, ringing in ears on a daily basis is normal for me. I just try not to pay too much attention to my symptoms unless I feel severe palpitations or about to faint. Honestly, I sometimes don't even know if I am unconscious(Syncope) or it's just Pre-syncope. But now I am going to write everything down and check my BP/HR regularly...keeping a journal is a great idea! My HR now, sitting is 105-119 and standing is 120-132.
I did get an Echo done and it is ok except for trace mitral regurgitation, mild tricuspid regurgitation and hypermobile interartrial septum which I am told is normal. I have also made an appointment with a Neurologist for Dysautonomia.
Will definitely keep you guys posted!
Thanks Tom for all the info on the 30 day monitor. No, I didn't know that the cost is for the actual monitoring.Thanks! It sounds pretty cool. I will have the advantage of having the implantable during swimming/ shower etc but with the 30 day looks like I can just put it on to the electrodes easily if I feel symptomatic too! That's great to know :)
Aah! didn't think that the cost of the implanatable will be more...So, they charge you again when it has to come out? That's a real bummer :(
I did get an Echo done and it is ok except for trace mitral regurgitation, mild tricuspid regurgitation and hypermobile interartrial septum which I am told is normal. I have also made an appointment with a Neurologist for Dysautonomia.
Will definitely keep you guys posted!
Thanks Tom for all the info on the 30 day monitor. No, I didn't know that the cost is for the actual monitoring.Thanks! It sounds pretty cool. I will have the advantage of having the implantable during swimming/ shower etc but with the 30 day looks like I can just put it on to the electrodes easily if I feel symptomatic too! That's great to know :)
Aah! didn't think that the cost of the implanatable will be more...So, they charge you again when it has to come out? That's a real bummer :(
I wanted to add something. Of course wtih an implanted recorder, you can swim, shower, etc. You cannot do this with an external recorder. You must take it off to shower, however you can leave the eledtrodes on if you wish. They are reusuable so long as they remain securly fixed against your skin.
You'll have to judge as to whether an implanted recorder is worth the advantage to having the "24/7, all the time, anywhere" option they offer.
You'll have to judge as to whether an implanted recorder is worth the advantage to having the "24/7, all the time, anywhere" option they offer.
As you may already know, the cost for the 30 day monitor lie not in the device itself, but in the monitoring charges.
Both devices are set up beforehand with criteria and set points based on you particular condition. If you suffer from bradycardia, the recorder can be set to auto record if your pulse drops below a programmed set point.
The cool thing about these recorders is they're always recording your heart. New data is streaming on as old data is sliding off, so in other words, it's not a complete 30 day recording of your heart. There may be only minutes of actual memory available to record your heart. The advantage of this is when an event happens, the recorder can automatically jump back a preset time and catch you going into the event, not just when you're into it. SO what it will do is jump back a preset time, say 1 minute and commit the event to a memory slot. Again, the recorder will be set to record to the memory slot for a particular amount of time. Once the time period expires, the memory slot is closed and locked. The recorder usually has 3 memory slots. They can be set to auto-trigger or the user can force a recording by pressing a button. The preset criteria is followed in a manual recording.
To give you an short example:
I went into SVT one night, and the recorder auto-triggered, jumping back one minute and thus catching the initiation of the event. It put this data into memory slot #1. After three minutes, the recorder closed the memory slot and beeped indicating it was complete. However, I was still in SVT. After some time, I was successful in slowing it down by doing Valsalva. I immediately pressed the button which forced a recording in slot #2. the recorder jumped back 1 minute, and started to fill the slot with data which included my heart dropping out of SVT and returning to NSR. Afterwards, I called the monitoring lab and downloaded the data. The technician was glad to see that I had the wherewithall to press the button in order to catch me coming out of it. this data proved invaluable in determining my particular condition and was absolutely key in getting me onto a path for a cure.
I would guess and say that you could do at least three 30 day monitor events and not equal the cost to implant a device in your chest wall. Remember, it has to out too!
Both devices are set up beforehand with criteria and set points based on you particular condition. If you suffer from bradycardia, the recorder can be set to auto record if your pulse drops below a programmed set point.
The cool thing about these recorders is they're always recording your heart. New data is streaming on as old data is sliding off, so in other words, it's not a complete 30 day recording of your heart. There may be only minutes of actual memory available to record your heart. The advantage of this is when an event happens, the recorder can automatically jump back a preset time and catch you going into the event, not just when you're into it. SO what it will do is jump back a preset time, say 1 minute and commit the event to a memory slot. Again, the recorder will be set to record to the memory slot for a particular amount of time. Once the time period expires, the memory slot is closed and locked. The recorder usually has 3 memory slots. They can be set to auto-trigger or the user can force a recording by pressing a button. The preset criteria is followed in a manual recording.
To give you an short example:
I went into SVT one night, and the recorder auto-triggered, jumping back one minute and thus catching the initiation of the event. It put this data into memory slot #1. After three minutes, the recorder closed the memory slot and beeped indicating it was complete. However, I was still in SVT. After some time, I was successful in slowing it down by doing Valsalva. I immediately pressed the button which forced a recording in slot #2. the recorder jumped back 1 minute, and started to fill the slot with data which included my heart dropping out of SVT and returning to NSR. Afterwards, I called the monitoring lab and downloaded the data. The technician was glad to see that I had the wherewithall to press the button in order to catch me coming out of it. this data proved invaluable in determining my particular condition and was absolutely key in getting me onto a path for a cure.
I would guess and say that you could do at least three 30 day monitor events and not equal the cost to implant a device in your chest wall. Remember, it has to out too!
I have presyncope almost every day though I don't have the nausea or sweating and palpitations. I only had those symptoms when I passed out. But I also had a fiborid tumor on my uterous at the time as well which caused heavy menstral periods so that could have been a factor in my situation. I know when my bp gets low especially if I am exercising I will feel the symptoms you describe so it really does sound like a low bp issue though if I down a lot of water it seems to really help me but it doesn't seem to work for you so keep at finding a reason. And just so you know home monitors seem to have difficulty reading low bp so you may pass the threshold of good low into obviously a danger zone where one can pass out. Why it is low is another story. Finding out why is key here. And getting your heart evaluate is a very good place to start. I might even push to have an echo done to make sure your heart is structurally fine. If that comes back normal that will be a big relief. Then you can reinvestigate if it is an autonomic issue or even possibly a lung issue. In general the readings you have given are not alarming but something is obviously going on so just keep on top of it and you should find some resolution at some point. These things can take a while but just hang in there and be persistent. You really do have to be your own best advocate when you know something needs attention. So stay strong and keep us posted on how you are doing.
Have an Answer?
You are reading content posted in the Heart Rhythm Community
Are there grounds to recommend coffee consumption? Recent studies perk interest.
Salt in food can hurt your heart.
Get answers to your top questions about this common — but scary — symptom
How to know when chest pain may be a sign of something else
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
