Confirm Rx® insertable cardiac monitor (ICM)

Case contributed by Dr Ashesh Ishwarlal Ranchod

Presentation

Incidental finding. The patient presented for thoracic spine X-rays with a history of upper dorsal spinal pain.

Patient Data

Age: 50 years
Gender: Male

An incidental finding of an insertable cardiac monitor (ICM) on thoracic spine X-rays, specifically a Confirm Rx® ICM (Model DM3500).

The previous chest X-ray was retrieved from PACS for review and confirmation.

This confirmed the ICM within the typical anterior 4th intercostal space at a slight angle to the sternum and along the axis of the heart.

Case Discussion

The patient has a Confirm Rx® ICM (Model DM3500), insertable cardiac monitor.

This was originally called a St. Jude Confirm Rx® DM3500, the name changed once Abbott acquired St Jude medical in January 2017.

It is used to monitor patients with vertigo, palpitations, chest pain, syncope, dyspnea, cardiac arrhythmias, and atrial fibrillation.

It is usually inserted in the 4th anterior intercostal space either at 45 degrees relative to the sternum or parallel to the sternum or anterolateral, inframammary between the 5th and 6th ribs.

The device is MRI conditionally safe as per protocols for 1.5 Tesla MRI.

The usual adverse events apply to all foreign insertable devices specifically local allergic reactions, bleeding and hematoma formation, chronic nerve damage, erosion, excessive fibrous tissue growth, extrusion, migration, infection, keloid formation, and local cyst formation.

Disclosure: I, Ashesh I Ranchod, have no actual or potential ethical or financial conflict of interest about this device. This case is not intended to be a personal endorsement or recommendation of this product.

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