[Sub-pectoral implantation of defibrillators: intraoperative data and long-term outcome].
The present study examined the perioperative mortality and morbidity and lead-related complications in patients who had a defibrillator with a transvenous lead system and subpectoral implantation of the generator. Fifty-four out of 57 consecutive patients (95%) received a transvenous lead system. One patient had an acceptable defibrillation threshold with an additional subcutaneous patch whereas no sufficient defibrillation threshold was found in another 2 patients. Two patients died due to congestive heart failure after implantation. Perioperative complications were observed in 4 patients (7%) including pericardial effusion, pocket hematoma, injury of the plexus brachialis and a pneumothorax. None of these complications required surgical intervention. Fifty-five patients were discharged from the hospital. During 27 +/- 10 months none of these patients died. Lead-related complications were observed in 3 patients (5.5%) including microdislocation in two and a outer conductor fracture in one of the lead.


CONCLUSIONS
Technical advancement such as a non-thoracotomy lead system and smaller devices have made the onc-incision approach and subpectoral implantation of the ICD generator clinical routine. Nevertheless complications related to the lead system can occur. Therefore frequent controls of patients with ICD are necessary.
Hief
C
C
Medizinische Abteilung, Ludwig-Boltzmann-Institut für Arrhythmieforschung, Wilhelminenspital der Stadt Wein, Osterreich.
Podczeck
A
A
Frohner
K
K
Nürnberg
M
M
Veit
F
F
Steinbach
K
K
D000328:Adult; D000368:Aged; D017147:Defibrillators, Implantable; D004566:Electrodes; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010369:Pectoralis Muscles; D016019:Survival Analysis; D014693:Ventricular Fibrillation / Q000209:etiology / Q000401:mortality / Q000628:therapy*