Implantable Loop Recorder (ILR): A Patient's Guide to What It Is, Why You Might Need One, and What to Expect

A patient comes in with the same story I hear several times a month. They had a fainting spell, or a brief episode of near-fainting, or a run of fluttery palpitations that came and went in a minute. Their primary care doctor ordered an EKG (the standard heart-rhythm tracing), which was normal. They wore a Holter monitor (a 24 to 48 hour wearable rhythm recorder) for a day or two, which caught nothing. They saw me and I ordered a 30-day event monitor (a patch that records when triggered), which also caught nothing. Now they are frustrated, and rightly so, because their symptoms are real, intermittent, and keep slipping through the nets.

That’s exactly the situation an implantable loop recorder is designed for. The device is about the size of a small paper clip, weighs three to four grams, and sits under the skin of the chest where it watches the heart rhythm continuously for years. If your event happens once every six months, a two-week patch will miss it. An ILR will not.

This guide walks through what an ILR is, when it makes sense, what the implant and follow-up actually involve, what the device can and can’t tell us, and how to live with one. I want you to walk in knowing what’s coming, and to walk out knowing how to get the most out of it.

What Is an Implantable Loop Recorder, in Plain English?

An implantable loop recorder is a tiny heart monitor that sits under the skin of your chest and continuously watches your heart rhythm for 2 to 6 years. It records only. It can recognize atrial fibrillation, slow rhythms with pauses, fast ventricular rhythms, and the rhythm during a fainting spell. It sends data wirelessly to your cardiologist’s monitoring center so the team can review what it sees and decide whether action is needed.

How the Device Looks and Where It Sits

Current devices are roughly the size of a paper clip, about 45 millimeters long, 8 millimeters wide, and 4 millimeters thick. They weigh about 3 to 4 grams. The case is biocompatible metal and plastic, with two metal electrodes on the surface that pick up the heart’s electrical signal through the skin. The device is implanted just under the skin on the left side of the chest, usually one to two centimeters left of the breastbone, around the fourth intercostal space (the gap between the fourth and fifth ribs). It sits in a small pocket the team creates with a delivery tool.

What It Records and What It Doesn’t

The device records the heart’s electrical rhythm (the same kind of tracing you’d see on an EKG, just from a different angle). It identifies abnormal patterns using built-in software, stores those tracings, and sends them to the cardiologist’s monitoring center. It also stores tracings around moments when you push the patient button to flag a symptom.

It does not pace your heart. It does not shock your heart. It does not measure blood pressure, oxygen, or anything else. It’s a one-trick device, and that’s exactly what we want from it.

How It Sends Data to Your Team

The device pairs with a bedside box or a smartphone app over Bluetooth. The box or app stays close to where you sleep. Once a day (or more often if there are alerts), the data is uploaded to the manufacturer’s secure cloud. Your cardiologist’s office, or a remote monitoring partner, reviews the tracings.

High-priority alerts (long pauses, sustained AF, sustained ventricular tachycardia) trigger a same-day or next-day call to the office. Routine downloads are reviewed at scheduled intervals, typically weekly or monthly.

How Long the Battery Lasts

Battery life depends on the device and on how much it has to record. Current devices run from about 2 years (older models) to 6 years (newest extended-life models). Once the battery is depleted, the device can either be removed in a short procedure or left in place (the body tolerates an inactive device just fine, and many patients prefer to leave it alone if it isn’t causing problems).

When Is an Implantable Loop Recorder the Right Tool?

An ILR makes the most sense when symptoms are infrequent but concerning, and shorter-term monitoring has been unrevealing. The two biggest indications are recurrent unexplained fainting where an arrhythmia is suspected, and cryptogenic stroke (a stroke without a clear cause) where the team is hunting for hidden atrial fibrillation. Other accepted indications include occasional concerning palpitations that have slipped through patches, monitoring after AFib ablation, and tracking premature ventricular beats over months.

Recurrent Unexplained Fainting (Syncope)

If you’ve fainted more than once, your basic workup has come back normal (EKG, echocardiogram, often a Holter or patch), and your story doesn’t sound like classic vasovagal fainting (the kind with warning warmth, nausea, and an obvious trigger), an ILR is often the right next step. The diagnostic yield is high: studies have shown around 55 percent yield with an ILR versus 19 percent with conventional testing for unexplained fainting. For more on how the fainting workup branches, see our overview of lightheadedness versus passing out and our deeper guide to tilt table testing.

The way to think about it: if your event happens once a year, your odds of catching it on a 2-week patch are roughly 1 in 26. Over a 3-year ILR window, those odds are close to 100 percent.

Cryptogenic Stroke

About a third of ischemic strokes are classified as cryptogenic, meaning the standard workup doesn’t find a clear cause. Paroxysmal AFib (intermittent AFib that comes and goes) is one of the likely culprits in many of these cases, and it can be hard to catch on short-term monitoring because the episodes may be brief and silent.

The CRYSTAL-AF trial was the landmark study. It randomized 441 adults with recent cryptogenic stroke to either an ILR or conventional follow-up. AFib was detected in 8.9 percent of ILR patients at 6 months, 12.4 percent at 12 months, and 30 percent at 36 months. The conventional group detected AFib in 1.4 percent, 2 percent, and 3 percent at those same timepoints. The ILR was 6 to 10 times more likely to find AFib than usual care.

The current AFib guidelines support extended monitoring after cryptogenic stroke, with an ILR reasonable when maximum sensitivity is the goal. The decision hinges on your CHA2DS2-VASc score (a stroke-risk score for people with AFib) and whether you’d be a reasonable candidate for anticoagulation if AFib were found.

Infrequent Concerning Palpitations

If you’ve had palpitations that sound like a real arrhythmia in the history (sudden onset, sudden offset, near-fainting at times, lasting more than a few seconds), but they happen too infrequently to be caught on a 2-week or 30-day patch, an ILR is often the most efficient way forward. Diagnostic yield for palpitations runs 80 to 90 percent over the device’s battery life.

Monitoring After AFib Ablation

After a catheter ablation for AFib, the team wants to know whether AFib has truly stayed away. For patients whose symptoms during AFib are vague or unreliable, an ILR provides continuous monitoring through the blanking period (the first 3 months after ablation, when occasional AFib episodes don’t yet count) and beyond, so the team can make medication decisions based on actual rhythm data rather than guesswork. Our guide to EP study and ablation covers the procedure side in more detail.

Frequent PVCs or Non-Sustained VT

For people with frequent premature ventricular contractions (extra beats from the bottom of the heart, called PVCs) or non-sustained ventricular tachycardia (short runs of fast ventricular rhythm that stop on their own), an ILR can quantify how much rhythm activity is happening over months, which informs decisions about medication or ablation. Most of the time a shorter-term patch is enough; an ILR is reserved for cases where long-term tracking changes the management.

When an ILR Is NOT the Right Choice

An ILR is the wrong tool if your symptoms happen more than once a week (a shorter patch will capture them at a fraction of the cost and effort), if your fainting fits a clear vasovagal pattern (no arrhythmia to catch), or if your symptoms aren’t actually arrhythmia-suggestive (lightheadedness from low blood pressure, for example, is better evaluated with orthostatic testing).

How Do I Prepare for an ILR Implant?

The implant is a short outpatient procedure under local anesthesia. Most teams ask you to come in with a clean dry chest, hold blood thinners only if they tell you to (most teams don’t), arrive having eaten normally, bring a list of your medications, and have a ride home (though many people drive themselves with no issue). Wear a button-down shirt for easy access to the chest. Total time at the clinic is usually 60 to 90 minutes.

Medications to Know About

Most teams continue your blood thinners (apixaban, rivaroxaban, warfarin) through the implant because the procedure is very superficial and the bleeding risk is low. Some teams ask you to hold for a day if you’re on dual antiplatelet therapy (aspirin plus clopidogrel) after a recent stent. If you’re on blood pressure medications, take them as usual on the morning of the procedure. Don’t stop or change anything without explicit instructions.

Eating and Drinking

Unlike many cardiac procedures, an ILR implant doesn’t require fasting because there’s no IV sedation in most cases. You can eat breakfast normally. Drink water. Take your medications.

What to Wear

A loose button-down or zip-up shirt so the team can access your chest without you having to pull a top off over your head. Avoid one-piece outfits. Bring a sweater because clinic rooms run cold.

What to Bring

Photo ID and insurance card. A current medication list. The bedside monitor box if you’ve already received one (some labs send it home in advance). Phone and charger.

Hygiene

Shower the morning of the procedure. Wash the left side of your chest with soap and water. Don’t apply lotion, deodorant, or powder to the chest area on procedure day. Don’t shave the area aggressively; the team will trim hair if needed.

Arranging Transportation

Most people drive themselves home after an ILR implant. There’s no sedation, you’re not impaired, and you can use your left arm normally afterward. If you’re at all anxious or have other health concerns, arrange a ride for peace of mind.

Setting Up the Bedside Monitor

The bedside monitor needs to be plugged in within Bluetooth range of where you sleep, usually within 6 to 10 feet of the bed. Don’t put it in a closet or on a different floor. Some teams now use a smartphone app instead, which lives on your phone and uploads automatically; the app needs Bluetooth and Wi-Fi to talk to the device and the manufacturer’s cloud.

What Happens on the Day of the Implant?

You’ll check in, change if needed, and meet the team. The procedure room is a small minor-procedure room, not a full operating room. The implant takes about 10 to 15 minutes from local anesthesia to final dressing. After 15 to 30 minutes of observation, you go home. Most people are back to normal activities the same day, with restrictions on heavy lifting and arm exercise for about a week.

Check-In and Pre-Procedure Setup

You’ll fill out paperwork, change into a gown or just open the front of your shirt, and have your blood pressure and pulse checked. The team will confirm your medication list, your indication for the device, and your understanding of what’s about to happen.

Positioning and Sterile Prep

You’ll lie on your back. The team washes the left side of your chest with antiseptic, drapes the area, and exposes the implant site (about an inch to the left of the breastbone, around the fourth intercostal space).

The Local Anesthesia

A small amount of lidocaine (a numbing medicine) is injected under the skin where the device will sit. It stings for about 5 to 10 seconds as it goes in, then the area goes numb within a minute. The numbness lasts an hour or two, well past the procedure time.

The Implant Itself

A small nick (about 6 to 8 millimeters, smaller than a pencil eraser) is made through the numb skin. The device sits at the end of a delivery tool that looks like a thick pen. The team inserts the device through the nick, slides it into place, and removes the delivery tool. You may feel pressure but should not feel sharp pain. If you do feel pain, tell the team and they’ll add more numbing medicine.

Closing the Incision

The nick is closed with a single dissolvable suture or with surgical glue. A small bandage covers the site.

Testing the Device

Before you leave, the team uses a wireless programmer to confirm the device is talking to the bedside monitor or smartphone app, that the signal quality is good, and that the recording is working. They may have you sit up or take a few deep breaths to confirm signal stability with movement.

Observation and Discharge

You’ll stay in the office for 15 to 30 minutes for observation. Once the team is satisfied, you go home. You’ll get printed instructions for site care and follow-up.

What Should I Watch for After the Implant?

Most people have soreness at the site for a few days and a small bruise that fades over a week or two. Keep the site dry for 24 to 48 hours. No heavy lifting or vigorous arm exercise for about a week. Call the team for any signs of infection (redness, warmth, drainage, fever) or for new symptoms that feel different from your baseline.

Site Care the First Few Days

Keep the bandage dry for 24 to 48 hours. After that, you can shower (let water run over the site, but don’t scrub). Pat dry. No bath, hot tub, or swimming for at least 7 to 10 days. Don’t pick at the steri-strip or surgical glue; let it fall off on its own.

Activity Restrictions

No heavy lifting (over 10 to 15 pounds) for one week. No vigorous arm exercise (push-ups, pull-ups, kettlebell swings) for one week. Light arm motion is fine immediately, including driving, typing, light cooking. Most people return to desk work the same day or the next day.

Pain Management

Acetaminophen (Tylenol) is enough for most people. Avoid NSAIDs (ibuprofen, naproxen, aspirin unless prescribed) for the first few days because they slightly increase bleeding risk. The pain typically lasts 2 to 4 days and is mild.

Signs of Infection

Call the team for: redness spreading more than a centimeter from the site; warmth around the site; persistent or thick drainage; pain that’s getting worse instead of better; or fever over 100.4 degrees Fahrenheit. Infection at the site is uncommon (well under 1 percent) but treatable when caught early. The treatment is usually antibiotics, occasionally device removal.

Bruising

A small bruise (the size of a quarter or a half dollar) at the implant site is normal. A larger bruise that’s expanding, painful, or warm warrants a call. Bruising fades over 1 to 3 weeks and goes through the usual color progression.

When to Use the Patient Button

If you have your symptoms (palpitations, near-fainting, dizziness), push the patient button on the bedside monitor or tap the symptom button in the smartphone app. This marks the time on the recording so the team can pull the tracing from that exact moment. Use it liberally; it’s one of the most useful tools the device has.

When to Call the Cardiology Office

Call the office within a day for any of: a new lump or bulge at the implant site; the device feels like it’s working its way out; the bedside monitor stops talking to the device for more than 24 hours; you push the patient button and want to confirm it was captured; any new symptom that worries you.

When to Go to the ER

Go to the ER or call 911 for severe chest pain, sudden shortness of breath, fainting with injury, signs of stroke (sudden weakness, slurred speech, vision loss, severe headache), or any other clearly emergent symptom. The ILR doesn’t replace clinical judgment in an emergency.

What Does the Device Find and How Does My Team Use That?

Your team reviews the tracings the device flags. If AFib is confirmed, the conversation is about anticoagulation. If a long pause or slow rhythm is found, the conversation is about a pacemaker. If sustained ventricular tachycardia is found, the conversation is about a defibrillator. If nothing dangerous is found over the device’s battery life, that’s also useful information: it reassures us that a life-threatening rhythm isn’t causing your symptoms and redirects the workup toward non-arrhythmic causes.

Atrial Fibrillation

The most common diagnostic find is AFib, especially in cryptogenic stroke patients. Confirmed AFib changes management: if you’re at meaningful stroke risk (CHA2DS2-VASc score of 2 or higher), starting anticoagulation reduces your risk of a future stroke.

The catch is that not every flagged episode is real AFib. A large fraction of automated alerts are false positives (extra beats, muscle artifact, sensing issues) that need a trained human to review. Your team filters out the noise and acts only on confirmed AFib.

Slow Rhythms and Long Pauses

Sustained slow heart rates (under 40 to 50 beats per minute when awake) or long pauses (over 3 seconds, sometimes longer at night) point toward sinus node dysfunction or heart block. The treatment is usually a pacemaker. The ILR’s role is documentation: catching the pause and tying it to a symptom (fainting, near-fainting) makes the pacemaker decision clear.

Fast Ventricular Rhythms

Runs of ventricular tachycardia, especially sustained or hemodynamically meaningful runs, change management substantially. The decision tree may lead to an implantable defibrillator, an electrophysiology study with possible ablation, or medication adjustment, depending on the underlying heart disease and the rhythm characteristics. See our overview of ventricular tachycardia for more.

The Rhythm During a Fainting Spell

For unexplained syncope, the most valuable find is a captured tracing during an actual fainting event. The rhythm at that moment is the answer: long pause, AFib with rapid response, ventricular tachycardia, normal sinus rhythm (suggesting non-arrhythmic cause), or anything else. The treatment follows from what the tracing shows.

A Negative Test

Sometimes the ILR runs for years and never captures anything concerning. That’s a useful finding too. It reassures us that a dangerous arrhythmia isn’t lurking and redirects the workup toward orthostatic causes, vasovagal reflex, medication effects, or non-cardiac causes of the symptom.

How Long Does the Device Stay In?

The device stays in as long as you need it and as long as the battery lasts. If the diagnosis is captured in month 6, the device can come out at that point. If the device runs through its full 2 to 6 year battery life without capturing the rhythm you came in for, you and your team decide together whether to remove it, leave it in place, or replace it with a new one. Most people whose device has fulfilled its purpose choose to have it removed.

Removing the Device

Removal is a similar short procedure to implant. Local anesthesia at the site, a small nick (often through the original scar), the device is grasped with a tool and slid out, the nick is closed. Total time about 5 to 10 minutes. Recovery is similar to the implant: mild soreness for a few days, no heavy lifting for a week.

Leaving an Inactive Device in Place

The devices are biocompatible and the body tolerates them well long-term. If your device has reached end of battery and isn’t bothering you, leaving it in place is a reasonable choice. Some patients leave them indefinitely with no issue.

Replacing the Device

If your indication is ongoing (recurrent syncope still occurring, cryptogenic stroke still being worked up, AFib ablation surveillance still relevant), you and your team may decide to replace the device when the battery runs out. The replacement is typically done in the same area as the original.

What Does Daily Life Look Like With an ILR?

Almost normal. The device is small, sits flat under the skin, and most people stop noticing it after a few weeks. You can travel, exercise, fly, swim, work in any job, and have most other medical procedures without issue. A few specific things to know: airport security is fine, you don’t need a wallet card except for travel reassurance, and MRI requires coordination with the cardiology team.

Travel

The device doesn’t trigger airport metal detectors in a way that requires special handling, but a wallet card stating you have an implanted cardiac monitor is helpful for international travel and for any unexpected medical encounter. The device transmits via Bluetooth, which works internationally with most smartphone apps; the bedside-monitor models require local power and may need a travel adapter.

Exercise and Sports

No restrictions after the first week. You can run, cycle, swim, lift weights, do CrossFit, play contact sports (with the same care as anyone would). The device sits in a protected pocket under the skin and is well anchored after a few weeks.

Bathing and Swimming

After the first 7 to 10 days, normal showering, baths, swimming, and hot tubs are all fine.

Sex

Normal activity within a week. No restrictions.

Driving

No restrictions from the ILR itself. If your underlying condition (fainting, recent stroke) has driving restrictions, those are unchanged.

Work

Most people return to desk work the same day or the next. Manual labor jobs may want to wait a week for lifting restrictions. No long-term restrictions.

Other Medical Procedures

Most medical procedures (dental work, surgery, routine imaging) are fine. MRI requires pre-procedure interrogation and post-procedure interrogation (a 15-minute office visit on each end). Cautery during surgery is generally fine. Diathermy and certain physical therapy modalities should be avoided directly over the device.

Wireless Interference

The device is designed to function around everyday wireless signals. Phones, Wi-Fi routers, microwaves, induction stoves, and security systems do not interfere. Strong industrial magnets (some welding equipment, large electric motors) may need to be avoided; check with your cardiology team if your work environment includes these.

How Often Do I Need to Be Seen After the Implant?

Routine schedule is a check at 1 to 2 weeks (in person or by phone, to confirm site healing and review baseline data), then every 3 to 6 months in person (or by remote download with phone follow-up), with continuous remote monitoring in between. If the device flags something high-priority, you’ll hear from the team within a day. If nothing’s flagged, the routine schedule applies.

The Two-Week Check

A brief visit to look at the implant site, make sure healing is on track, and confirm the device is talking to the bedside monitor or app. Often handled as a phone call if the site looks normal.

Quarterly or Semi-Annual In-Person Visits

A device interrogation in clinic, where the team downloads the full record and reviews any flagged events. This visit is usually 20 to 30 minutes.

Continuous Remote Monitoring

Between visits, the bedside box or smartphone app uploads daily. High-priority alerts trigger a same-day or next-day call. Routine downloads are reviewed at scheduled intervals by the device monitoring team.

How to Reach Your Team

Most cardiology practices have a dedicated device clinic with a separate phone line and email. Use the dedicated line for device-related questions; use the general office line for non-device clinical questions.

Common Questions Patients Ask Me

Will the implant hurt?

The local anesthesia stings for 5 to 10 seconds as it goes in. After that, you should feel pressure but not sharp pain during the implant. Soreness afterward is mild and lasts 2 to 4 days. Acetaminophen is usually enough.

Will I be able to feel the device?

For the first couple of weeks, yes, you’ll feel a small firm object under the skin if you press on it. After the tissue heals around it, most people stop noticing it. Some people forget it’s there entirely.

Can the device shock me or pace me?

No. An ILR only records. It doesn’t deliver any therapy. Pacemakers and defibrillators are different devices.

How accurate is the AFib detection?

The algorithms are very sensitive (they catch most real AFib) but not very specific (they also flag a lot of things that aren’t AFib). That’s why every alert is reviewed by a person before any action is taken. False positives are common and managed routinely by the monitoring team.

What happens if I have a symptom?

Push the patient button on the bedside monitor or tap the symptom button in the smartphone app. This marks the time on the recording. Your team will review the tracing from that moment when they look at the next download.

Can I have an MRI with this device?

Yes, all current ILRs are MRI-conditional, meaning safe in the scanner under specific conditions (usually a 1.5-T or 3-T machine). The protocol is to interrogate the device before the scan to capture any stored data, then again after to clear any artifacts the scan may have generated. Tell the ordering provider you have an ILR so they can coordinate with your cardiology team.

What if I move or travel? Will the device still work?

Yes. The device travels with you. The bedside monitor needs a power outlet (with a travel adapter for international trips). The smartphone app works wherever your phone has Bluetooth and Wi-Fi or cellular data.

Will my insurance cover this?

Most insurance plans cover an ILR for accepted indications (unexplained syncope after a complete workup, cryptogenic stroke, recurrent palpitations after failed shorter monitoring). Prior authorization is often required. Your cardiology office handles this.

How long until I get an answer?

Depends on how often your symptoms happen. If they happen monthly, you may have your answer in 1 to 2 months. If they happen every 6 to 12 months, expect 6 to 18 months. The device runs continuously, so the wait is the wait for your event to recur, not a wait for the device to detect.

What if the device doesn’t find anything?

That’s also useful information. It reassures us that a dangerous arrhythmia isn’t causing your symptoms and redirects the workup toward orthostatic, vasovagal, or other non-arrhythmic causes. The negative result doesn’t mean the symptoms aren’t real; it just means the cause isn’t an arrhythmia.

Will I have a scar?

A small scar (5 to 10 millimeters, the size of a pencil eraser) at the implant site. Most heal well and fade noticeably over a year.

Can I sleep on that side?

Yes, after the first few days. Some people find it slightly uncomfortable to sleep on the left side for the first week; a pillow under the shoulder helps. After the area heals, sleep position doesn’t matter.

How Should I Plan My Calendar Around the Implant?

Block out 1 to 2 hours for the implant visit, the rest of the day for taking it easy at home, and a week of activity restriction (no heavy lifting, no vigorous arm exercise). Plan to use the patient button when symptoms happen. Schedule the 2-week follow-up before you leave the implant visit. Expect routine quarterly or semi-annual device checks after that.

A Week Before

Confirm the implant date and time. Review medication instructions (most teams don’t ask you to hold anything). Set up the bedside monitor in your bedroom or download the smartphone app per the team’s instructions. Plan a button-down shirt and a quiet day after.

The Day Before

Shower normally. Lay out comfortable clothes. Don’t apply lotion or deodorant to the left chest. Sleep normally.

The Morning Of

Shower, eat breakfast, take medications as usual. Drive yourself or arrange a ride. Arrive on time.

The Implant Day Itself

10 to 15 minute procedure, 15 to 30 minute observation, drive home. Take it easy in the afternoon. Don’t lift heavy. Watch the site for any concerning changes.

The First Week

Light activity. Site care per instructions. Acetaminophen for soreness. Use the patient button if you have symptoms.

Beyond the First Week

Resume normal activity including exercise and sports. Continue using the patient button for any symptoms. Watch for follow-up scheduling.

Reference Tables

Common Indications for an ILR

Current ILR Devices in U.S. Practice

Site Care Timeline After Implant

A Final Note From Me

An implantable loop recorder is the right tool when you need time on your side. If your symptoms are infrequent but potentially serious, or you’ve had a stroke of unclear cause and we’re trying to rule out silent AFib, an ILR gives us a monitoring horizon of years instead of days. Current devices are small, safe, and MRI-compatible. The implant is quick. The main costs are vigilance (someone reviewing alerts), patience (the event may still take months), and acceptance that a chunk of alerts will be false positives the care team will need to sort through.

If you’re a patient wrestling with unexplained fainting or a cryptogenic stroke workup, and shorter-term monitors haven’t given an answer, an ILR is often the move that gets you off the diagnostic treadmill. The data aren’t perfect, the yield isn’t 100 percent, and the implications of finding brief AFib are still being studied. But for the right patient in the right clinical context, an ILR has become one of the most useful tools in modern cardiology practice.

A few practical points worth repeating. Use the patient button. It’s one of the most useful tools the device has, and the symptom-rhythm correlation it produces is often what makes a diagnosis click. Keep the bedside monitor plugged in and within range, or keep the smartphone app installed and active; the device only helps if the data is flowing. Bring your cardiology team into the loop before any MRI. Watch the site for the first week and call the team for any redness, drainage, or fever. Beyond that, live your life normally.

If you have questions about whether an ILR makes sense in your case, or if you’ve already had one implanted and want to talk through what to expect, our office can help. We work closely with the electrophysiologists at San Diego Cardiovascular Associates who handle device implantation and remote monitoring. To get in touch, visit our practice website.

References

1. Sanna, Tommaso, Hans-Christoph Diener, Rod S. Passman, et al. “Cryptogenic Stroke and Underlying Atrial Fibrillation.” New England Journal of Medicine 370, no. 26 (2014): 2478-2486.

2. Joglar, Jose A., Mina K. Chung, Anastasia L. Armbruster, et al. “2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation.” Journal of the American College of Cardiology (2024).

3. Shen, Win-Kuang, Robert S. Sheldon, David G. Benditt, et al. “2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope.” Journal of the American College of Cardiology 70, no. 5 (2017): e39-e110.

4. Ko, Darae, Qiying Dai, David B. Flynn, et al. “Meta-Analysis of Randomized Clinical Trials Comparing the Impact of Implantable Loop Recorder Versus Usual Care After Ischemic Stroke for Detection of Atrial Fibrillation and Stroke Risk.” American Journal of Cardiology (2022).

5. Yaghi, Shadi, Luciano A. Sposato, Liqi Shu, et al. “Device-Detected Atrial Fibrillation in Patients With and Without Cryptogenic Ischemia: The ANTARCTICA Pooled Analysis.” Stroke (2025).

6. Spooner, Michael T., Steven R. Messe, Seemant Chaturvedi, et al. “2024 ACC Expert Consensus Decision Pathway on Practical Approaches for Arrhythmia Monitoring After Stroke.” Journal of the American College of Cardiology (2025).

7. Ferrick, Aysha M., Satish R. Raj, Thomas Deneke, et al. “2023 HRS/EHRA/APHRS/LAHRS Expert Consensus Statement on Practical Management of the Remote Device Clinic.” Heart Rhythm (2023).

8. Gauer, Robert L., Melanie F. Thomas, and Robert A. McNutt. “Palpitations: Evaluation, Management, and Wearable Smart Devices.” American Family Physician (2024).

Published on damianrasch.com. The above information was composed by Dr. Damian Rasch, drawing on individual insight and bolstered by digital research and writing assistance. The information is for educational purposes only and does not constitute medical advice.