Complications of implantable cardioverter defibrillator therapy: follow-up of 241 patients.
In order to determine the incidence of complications of implantable cardioverter defibrillator (ICD) therapy, 241 patients with a total of 353 ICD implantations were followed for 24 +/- 20 months. Complications were defined as any untoward effects experienced by the patient related to the ICD implantation and function or death within 4 weeks of implant or before hospital discharge. During follow-up, 129 of 241 patients (53%) had a total of 166 complications. An operative procedure was required to correct the complication in 50 of the 241 patients (21%). No patient died intraoperatively, but eight patients died within 4 weeks postoperatively or before hospital discharge. ICD infection required removal of the device in 13 patients (5%). Twenty-six patients (11%) had postoperative respiratory complications. Postoperative bleeding and/or thrombosis occurred in 11 patients (4%). Endocardial lead migration was observed in nine patients (4%) and lead adapter or insulation break occurred in nine patients (4%). Fifty-four patients (22%) experienced ECG-documented discharges for non-VT rhythm. In conclusion, although perioperative mortality in ICD patients is low, the majority of patients have complications during follow-up. Recognition of these complications may allow for advances in ICD technology and management strategies to avoid their occurrence.
Grimm
W
W
Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia 19104.
Flores
B F
BF
Marchlinski
F E
FE
D001424:Bacterial Infections / Q000453:epidemiology; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004562:Electrocardiography; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D013923:Thromboembolism / Q000453:epidemiology; D013997:Time Factors