Insertable cardiac monitor extraction technique: hook and reel

The use of insertable cardiac monitors (ICM) has been increasing because of their ability to provide long-term electrocardiographic monitoring and symptom correlation. Indications for implantation include evaluation of cryptogenic stroke, unexplained syncope, intermittent palpitations, and atrial fibrillation. When the ICM needs to be removed because of battery depletion and/or diagnostic revelation, its removal can be challenging because of its small size and the capsule that forms around the proximal end of the device. A simple technique is described that takes advantage of the ICM design to facilitate its successful extraction.