The implantable cardiac monitor and pocket infection

Abstract

Lauschke et al. [1] reported that a newly developed implantable cardiac monitor (ICM; BioMonitor) effectively detects patients with cardiac arrhythmia. In this prospective nonrandomized study, the BioMonitor provided safety results within the expected range. The implantation was successful in all 152 patients, and two device-related serious adverse events (pocket infections) occurred at 3 months.Cardiac implantable electronic devices (CIEDs) mainly include pacemakers, implantable cardiac defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. ICMs can also be added to this list. Previous trials reported that the incidence of CIEDrelated infections ranges from 0 to 12.6% [2,3]. Pocket infections prolong hospital stay and increase medical costs. Moreover, the increased incidence of infectious complications is associated with substantially elevated morbidity and mortality rates [4,5]. In this study, devices were implanted epifascially in 42% of the patients and subcutaneously in 52%. Although ICM implantation is regarded a simple process, the infection range was 1.3%.In this well-presented article by Lauschke and colleagues, two devicerelated serious adverse events (pocket infections) occurred by 3 months in two patients and the devices were explanted. No additional data are provided about these two patients. There are various host-related and procedurerelated factors associated with CIED infections, including diabetes mellitus, chronic obstructive pulmonary disease, corticosteroid use, renal insufficiency, malignancy, heart failure, preprocedural fever, anticoagulant drug use, skin disorders, postoperative hematoma, and lack of antibiotic prophylaxis [6]. In light of this knowledge, it might be beneficial to know the baseline characteristics of these patients so as to avoid ICM infection.