A New Solution to a Rare Problem of Implantable Cardiac Device Hypersensitivity

Abstract

For this research, we have considered a case of a man aged 60 years who developed painless fluid accumulation in the implantable cardiac defibrillator (ICD) pocket site. The cardiovascular implantable electronic device initially appeared to be infected, but it was eventually determined that the cause was an allergic reaction, and a novel solution was implemented. For patients with nickel allergies, treatment typically includes avoiding nickel or replacing with gold-plated devices with new leads. Because of the subclavian vein thrombosis, the gold-plated generator was not replaced. ICD generators were covered with antibiotic-coated envelopes while waiting for the replacement. Hypersensitivity to cardiac devices was effectively treated with this technique. By routinely using the envelope, the very rare incidence of device hypersensitivity could further be reduced.

Keywords: acid fast bacilli (afb); antibiotic coated envelope; cardiovascular implantable electronic device (cied); implantable cardiac defibrillator (icd); pacemakers (pm).