Left Axillary Implantation of Loop Recorder versus the Traditional Left Chest Area: A Prospective Randomized Study

Abstract

This long-term randomized study confirmed that axillary access for ILR implantation is feasible, safe, well tolerated, and reliable in terms of device performance. Moreover, it is aesthetically superior to the standard approach and carries the potential of minimizing permanent scarring after ILR extraction.

Sensing performance, safety, and patient acceptability of long‐dipole cardiac monitor: An innovative axillary insertion

“…However, insertion in alternative positions might sometimes be evaluated, especially for cosmetic reasons. The ICM left axillary implantation demonstrated to be a valid alternative in a previous study with a different device technology . We confirmed this finding also with the novel‐long dipole ICM, where the presence of the flexible silicon antenna could be considered as a possible contraindication to this approach.…”

“…This technique might be particularly useful in terms of aesthetic advantages, as the surgical pectoral scar caused by the standard approach could be poorly tolerated especially by some patients (i.e., younger patients, women). Of note, differently from previous experiences, we performed axillary implantation with 45° angle relative to midaxillary line, better aligned to the cardiac vector. As compared to the standard location of the subcutaneous implantable cardioverter defibrillator generator, our approach is more cranial and closer to the anterior axillary line.…”

“…The tested axillary position consists of the same steps, with a final device positioning at the fourth/fifth intercostal space in the anterior axillary line with an inclination of around 45° to the midaxillary line (Figure ). Differently from a previous experience of axillary implantation characterized by a final “horizontal” position of the device, the 45° inclination was chosen in order to better align the sensing dipole to the heart vector.…”

“…However, the surgical scar on the pectoral region could create aesthetic problems, particularly for younger patients. A left axillary implantation approach has been recently developed to improve aesthetic result without compromising sECG quality and detection performances …”

Changes In R-wave Amplitude At Implantation Are Associated With Gender and Postures: Observations From The Confirm Rx™ Body Posture and Physical Activity Study

“…A QRS or R wave under-sensing and oversensing may re ect false asystole and false high ventricular rate episodes, respectively [15,16] and thus, mislead diagnosis. Although, recommendations for optimal positioning and procedural methodologies for implanting ICM have been investigated and provided some success, patient-speci c features and complexity of cardiac pathologies have confounded further progress, particularly for arrythmias/AF arising from syncope and cryptogenic stroke [17,18].…”