Presentation
A known cardiac patient presents with an acute myocardial infarct. Mobile X-rays performed in an intensive care setting.
Patient Data
The mobile X-ray demonstrates multi-chamber cardiomegaly, magnified in a supine series. There is an IJV, CVP, central trachea, with a satisfactorily sited endotracheal tube (ETT), a nasogastric tube (NGT), and overlying ECG leads and oxygen tubing. Features consistent with cardiac decompensation with pulmonary oedema in the setting of an acute myocardial infarct.
There is an unusual left hypochondrial/inframammary positioned implantable cardiac monitor (ICM) with an antenna in situ.
Case Discussion
This is an example of a Biotronik Biomonitor III implantable (injectable) cardiac monitor (ICM).
The benefit of this device is the increased sensing vector length in comparison to other ICMs1.2.
The device is made of titanium, coated in silicone, with a silicon flexible antenna with an electrode at its end1.2.
ICMs are usually placed in a parasternal ( parallel or at 45o ) or an inframammary anatomical location (as in this case).
Indications for implantable cardiac monitors include1:
arrhythmia
previous embolic stroke
syncope
post myocardial infarction and ventricular arrhythmia
Remember to check the MRI safety of all cardiac devices before any MR imaging study.
Disclosure: I, Ashesh I Ranchod, have no actual or potential ethical or financial conflict of interest in relation to this device. This case is not intended to be a personal endorsement or recommendation of this product.
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