Positive reactions were rated as follows: “1+”, erythema and edema “2+”, erythema, edema, and papules and “3+”, erythema, edema, papules, and vesicles. Patch test results were scored as negative “0” and as positive “1–3+”. Testing sites were evaluated 30 min after removing the patch test samples and monitored daily for 72 h. Patch testing samples were prepared according to the test kit protocol. Patch testing was conducted using an implantable cardioverter-defibrillator (ICD) Patch Test Kit (Medtronic Inc., St. ![]() Following complete resolution of pain several days after the explant a suspicion of device allergy arose and an allergist was consulted for patch testing.įigure 1: Presentation of the patient’s pectoral tissue during implantable loop recorder explant. The device was explanted without complication and cultures showed no infection. There were no clinical signs to suggest pocket infection at this time ( Figure 1). Over the ensuing weeks pain worsened and a decision to extract the device was made. She was recommended acetaminophen and regular follow-up. At this time the skin looked healthy, with no evidence of infection. Twenty-four hours after the implant the patient began to complain of localized chest pain and tenderness. The patient was implanted in the left parasternal region with an ILR (Reveal XT 9529, Medtronic Inc., St. Our first case involves a 43-year-old woman with severe obstructive sleep apnea who was referred to us for evaluation of paroxysmal atrial fibrillation. 4, 5 In this manuscript, we present the first two documented cases of ILR-induced allergy. 2, 3 While infection is regarded by the literature as a rare complication of ILR implantation, to date no cases of ILR allergy have been described. Both pocket-site infection and device allergy are recognized rare complications of cardiac device implantation. 1 Although a simple procedure, ILR implantation is not devoid of complications. Implantable loop recorders (ILRs) have become an increasingly important tool for extended ambulatory electrocardiographic monitoring. ![]() Manuscript received June 21, 2015, final version accepted June 29, 2015.Īddress correspondence to: Adrian Baranchuk MD FACC, FRCPC, Associate Professor of Medicine and Physiology Cardiac Electrophysiology and Pacing, 76 Stuart St., Kingston General Hospital, K7L 2V7, Queen’s University, Kingston, Ontario, Canada. The authors report no conflicts of interest for the published content. ![]() allergic contact dermatitis, ambulatory electrocardiography, hypersensitivity reaction, implantable cardioverter-defibrillator, implantable loop recorder. In this manuscript we report the first two documented hypersensitivity reactions to implantable loop recorders. Despite this, no allergic reactions to implantable loop recorders have as of yet been reported. Allergenic responses to cardiac rhythm defibrillators have been documented as rare but important complications. Implantable Loop Recorder HypersensitivityĭORAN DREW, BScH 1, ROZITA BORICI-MAZI, MD, FRCPC 2 and ADRIAN BARANCHUK, MD, FACC, FRCPC 1ġ Cardiology Division, Kingston General Hospital, Queen’s University, Kingston, Ontario, Canada.Ģ Division of Allergy & Immunology, Hotel Dieu Hospital, Department of Medicine, Queen’s University, Kingston, Ontario, Canada.ĪBSTRACT.
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