{
  "abstract": "Background\n\nInsertable cardiac monitors (ICMs) are widely used for long-term rhythm surveillance, yet explantation can be challenging because of fibrotic encapsulation, tissue variability, and device migration. Current removal typically relies on general surgical instruments, and no dedicated tool exists for difficult ICM explants.Objective\n\nThis study aimed to evaluate the performance of a purpose-built cardiac monitor extraction tool (CM-eX) compared with standard removal technique using benchtop and chronic animal models.Methods\n\nThe CM-eX was designed and fabricated. Benchtop testing used a 2-layer synthetic gel model simulating fibrotic encapsulation and subcutaneous tissue. 80 ICM removals were performed using CM-eX, standard instruments, or direct wire pullout. Metrics included removal time and peak insertion and removal forces. Electromyography was recorded as a measure of operator demand. Chronic animal testing was performed in 9 rats implanted bilaterally with ICMs and explanted after a 3-month survival period, with each animal serving as its own control.Results\n\nIn benchtop models, removal time was similar between the CM-eX and standard instruments (P = .40), whereas the CM-eX required significantly lower removal force than direct pullout (P < .0001). Overall EMG activity was similar between methods. In the chronic animal model, the CM-eX was associated with faster explant in 8 of 9 paired comparisons, with a mean reduction of 28% vs standard instruments. No device slippage or procedural complications were observed.Conclusion\n\nIn preclinical testing, the CM-eX demonstrated feasible ICM removal with reduced extraction force in benchtop models and directional improvements in explant time in an animal model. These findings support its potential to facilitate more controlled and consistent ICM explantation.",
  "abstract_shown": true,
  "affiliations": [
    "Children's National Medical Center, Washington, District of Columbia.",
    "Johns Hopkins University, Department of Mechanical Engineering, Baltimore, Maryland."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Bryan Gonzalez"
    },
    {
      "affs": [
        0
      ],
      "name": "Vanessa Ogueri"
    },
    {
      "affs": [
        0
      ],
      "name": "Devon Guerrelli"
    },
    {
      "affs": [
        1
      ],
      "name": "Justin D Opfermann"
    },
    {
      "affs": [
        0
      ],
      "name": "Mischa Cho"
    },
    {
      "affs": [
        0
      ],
      "name": "Charles I Berul"
    },
    {
      "affs": [
        0
      ],
      "name": "Ryan P O'Hara"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ee967mqvpe1xb.bib",
  "cited_by": 0,
  "doi": "10.1016/j.hroo.2026.07.003",
  "fulltext_url": "https://europepmc.org/articles/PMC13700384",
  "id": "ee967mqvpe1xb",
  "issns": [
    "2666-5018"
  ],
  "landing_url": "https://europepmc.org/article/MED/42936125",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2705|Cardiac pacing and defibrillation studies"
    ]
  ],
  "openalex": "W7167821076",
  "pdf_url": "https://europepmc.org/articles/PMC13700384?pdf=render",
  "pmcid": "PMC13700384",
  "pmid": "42936125",
  "published": "2026-07-09",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/ee967mqvpe1xb.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:22:24Z",
      "native_id": "MED:42936125",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42936125"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Cardiac pacing and defibrillation studies",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Preclinical and benchtop evaluation of a dedicated tool for insertable cardiac monitor explantation.",
  "title_text": "Preclinical and benchtop evaluation of a dedicated tool for insertable cardiac monitor explantation.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:24Z",
  "url": "https://research.draconitic.com/paper/ee967mqvpe1xb",
  "venue": "Heart rhythm O2",
  "versions": []
}