Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Apr 18;39(3):310-314.
doi: 10.1002/joa3.12852. eCollection 2023 Jun.

Cardiac implantable electronic devices (CIEDs) and allergy

Ermenegildo De Ruvo  1 , Mattia Petrungaro  2 , Lucia De Luca  1 , Edoardo Bressi  1 , Giuseppe Bruni  1 , Alessandro Fagagnini  1 , Domenico Grieco  1 , Anna Maria Martino  1 , Marco Panuccio  1 , Alessandro Politano  1 , Marco Rebecchi  1 , Leonardo Calò  1
Affiliations
Review

Cardiac implantable electronic devices (CIEDs) and allergy

Ermenegildo De Ruvo et al. J Arrhythm. .

Abstract

Advances in cardiac implantable electronic devices (CIEDs) have prolonged life expectancy in various medical settings. However, the issue of hypersensitivity to components of CIEDs is still a concern. Since 1970, allergic reactions to metallic and nonmetallic components of CIEDs have been reported. Hypersensitivity reactions to medical devices are rare and not fully understood. In some cases, diagnosis and treatment are difficult. Cardiologists should always keep in mind pacemaker allergy when a patient appears with wound complications and no signs of infection. Patch testing should be tailored toward the specific biomaterials used in a device, in addition to testing with standard screening allergens in select cases.

Keywords: allergic reactions; cardiac implantable electronic devices; hypersensitivity.

PubMed Disclaimer

Conflict of interest statement

No financial support was received and none of the authors has any conflict of interest.

Figures

FIGURE 1
FIGURE 1
A patient with a pacemaker referred to erythema and swelling at the site of CIED insertion after replacement with a new device covered with parylene. The patient also complained of pruritus and pain in the device wound.
FIGURE 2
FIGURE 2
A dual‐chamber pacemaker has a titanium alloy. The transition part serves to connect the electrodes with the generator and it is made of a synthetic resin (bisphenol A epoxy resin, epichlorohydrin, o‐cresyl glycidyl ether, bisphenol F, and ethylenediamine dihydrochloride). The electrodes used in pacing and defibrillation systems are made of polyurethane, silicone, or their combinations, whereas their internal parts are made of metal alloys (nickel, cobalt, chromium, and molybdenum) but are not in contact with human tissue or blood.
See this image and copyright information in PMC

References

    1. Glikson M, Nielsen JC, Kronborg MB, Michowitz Y, Auricchio A, Barbash IM, et al. 2021 ESC guidelines on cardiac pacing and cardiac resynchronization therapy. Europace. 2022;24(1):71–164. - PubMed
    1. Raatikainen MJ, Arnar DO, Merkely B, Camm AJ, Hindricks G. Access to and clinical use of cardiac implantable electronic devices and interventional electrophysiological procedures in the European Society of Cardiology Countries: 2016 Report from the European Heart Rhythm Association. Europace. 2016;18(Suppl 3):iii1–iii79. - PubMed
    1. Ellenbogen KA, Hellkamp AS, Wilkoff BL, Camunas JL, Love JC, Hadjis TA, et al. Complications arising after implantation of DDD pacemakers: the MOST experience. Am J Cardiol. 2003;92:740–1. - PubMed
    1. Udo EO, Zuithoff NP, van Hemel NM, de Cock CC, Hendriks T, Doevendans PA, et al. Incidence and predictors of short‐ and long‐term complications in pacemaker therapy: the FOLLOWPACE study. Heart Rhythm. 2012;9:728–35. - PubMed
    1. Parsonnet V, Bernstein AD, Lindsay B. Pacemaker‐implantation complication rates: an analysis of some contributing factors. J Am Coll Cardiol. 1989;13:917–21. - PubMed