Key result
Coating an implantable cardiac defibrillator generator with an antibiotic-coated envelope successfully prevented recurrent fluid accumulation due to nickel hypersensitivity over three months of follow-up.
Why the study?
Does covering an ICD generator with an antibiotic-coated envelope treat device hypersensitivity in a patient with nickel allergy?
Case Report (n=1)
Does covering an ICD generator with an antibiotic-coated envelope treat device hypersensitivity in a patient with nickel allergy?
Using an antibiotic-coated envelope to cover an ICD generator may be an effective novel solution for managing device hypersensitivity in patients with nickel allergies who cannot undergo device replacement.
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.
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Al-Zakhari et al. (2021) conducted a case report in Implantable cardiac device hypersensitivity (n=1). Antibiotic-coated envelope was evaluated on Re-accumulation of fluid in the ICD pocket. Coating an implantable cardiac defibrillator generator with an antibiotic-coated envelope successfully prevented recurrent fluid accumulation due to nickel hypersensitivity over three months of follow-up.
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