Periprocedural antibiotics during loop recorder implantation and incidence of infection

Background Implantable loop recorders (ILRs) are subcutaneous devices widely used for the evaluation of suspected arrhythmias. Given the minimally invasive nature of the implantation procedure, routine antibiotic prophylaxis is not generally recommended by current guidelines. Aim This study aimed to evaluate the incidence of post-procedural infection following ILR implantation and to compare outcomes between patients who did and did not receive peri-procedural antibiotic prophylaxis. Methods We retrospectively analyzed 516 consecutive patients who underwent ILR implantation over a 10-year period (2016 – 2026). Patients were divided into two groups: Group A (n=223), who did not receive peri-procedural antibiotics, and Group B (n=293), who received antibiotic prophylaxis. All patients were followed for a minimum of one year after implantation. The primary endpoint was the occurrence of device-related infection. Results During the one-year follow-up period, no infections were documented in either group. Conclusions ILR implantation is associated with an exceedingly low incidence of infection. In this cohort, the use of peri-procedural antibiotic prophylaxis did not provide any observable clinical benefit, supporting current recommendation against its routine use.