Migration of an implantable loop recorder into the pleural space

Introduction Implantable loop recorders (ILRs) are most commonly used in patients with unexplained palpitations or syncope as well as suspected or known atrial fibrillation. The device most commonly being used today is the Medtronic Reveal LINQ (Minneapolis, MN); with a volume of,1.2 cc, it is designed for insertion using a greatly simplified technique. Specifically, the ILR is provided preloaded into an insertion tool that is used to deliver the device subcutaneously through a small incision, which is then closed using surgical glue, surgical tape, sutures, or staples. The LINQUsability study provided first in-human experience in an initial cohort of 30 patients followed for a month. The only remarkable findings were implant site pain in 2 patients and a superficial wound infection in 2 patients. In this case report, we describe a patient in whom the ILR progressively migrated from the subcutaneous into the left pleural space.