CONGRESS ABSTRACT

Background: ILR is indicated in patients with unexplained syncope to identify the cause of T-LOC. There are few cases described in the literature of migration or extrusion of the device. This study aimed to perform a meta‐summary of case reports to characterize patients who experienced ILR migration. Methods: We searched for case reports published from January 2017 to 2024. Case reports of migration of ILR were included. Finally, 7 eligible case reports/case series were included in our meta‐summary. Patients' characteristics, ILR implant technique and diagnostic properties were collected. Results: A total of 7 patients who experienced migration of ILR were examined. The ILR implanted were Biomonitor II/III in four patients and Medtronic linq in the three ones. Regarding the time to event, all patients experienced migration within 35 days following ILR implantation. No information about the possible causes of ILR migration was provided. The clinical suspicion arose from chest pain in 5 cases, from signal abnormalities on ILR interrogation by the anterior chest in one case, and from signal abnormalities of home ILR monitoring in one case. The migration of ILR was confirmed in post‐operative CXR and CT-scan in all cases. ILRs migrated most commonly into the left inferior part of the pleural cavity (n: 4; 57.14%). The management of ILR migration ILR was based on the device movement by VATS (n: 5; 71.4%) and open surgical intervention (n: 2; 28.6%). Discussion: ILR implantation is a simple procedure burdened by low intraoperative complications. The main complications are represented by short-term local pain, hematomas, and local discomfort. Rarely, episodes of extrusion from the skin may occur. Few cases describe ILR migration. From the results of our analysis, ILR migration is a rare complication that occurred in 50% in the early post‐implant period (< 7 days) and always within the following 35 days. ILR migration may be caused by an intra-operative technical mistake. The suspicion of ILR migration is mainly derived from the appearance of symptoms.The diagnosis of ILR migration occurred mainly with the use of radiological techniques. Device removal was primarily based on the use of the VATS technique. In one case remote ILR monitoring was able to detect ILR migration. Conclusion: Intrapleural migration is a rare complication of ILR implantation. Larger studies are needed to increase the knowledge and improve the prevention of ILR migration.