Parallel lines in the left breast - implantable device

Case contributed by Dr Giorgio M Baratelli

Presentation

Routine breast ultrasound examination

Patient Data

Age: 40 years
Gender: Female

Two parallel hyperechoic lines, with a posterior acoustic shadow, are detected in the inferior-internal quadrant of the left breast.

The arrows show the upper and the lower end of the device.

Patient has given permission for photographs to be used online at Radiopaedia.org.

The device: insertable cardiac monitor (ICM)

Disclosure: I, Giorgio M Baratelli, 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."

Case Discussion

The lines represent reverberation artifacts of a small wireless insertable cardiac monitor (ICM), also known as an implantable loop recorder (ILR). This particular device is a Medtronic Reveal LINQ insertable cardiac monitoring system.

The device is implanted subcutaneously with a vertical or oblique (45° angle) orientation in the left parasternal region, under local anesthesia for a continuous long-term recording the heart's electrical activity.

The dimensions of the device are 44.8 mm x 7.2 mm x 4.0 mm and the volume is 1.2 mL;  the weight is 2.5 g.

A lithium carbon monofluoride battery allows up to three years of life.

It is indicated for patients experiencing infrequent symptoms that require long-term monitoring or ongoing management, as patients with clinical syndromes or situations at increased risk of cardiac arrhythmias or patients who experience transient symptoms such as dizziness, palpitation, syncope, and chest pain, that may suggest a cardiac arrhythmia. This device has not been specifically tested for pediatric use.

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