title: [Sub-pectoral implantation of defibrillators: intraoperative data and long-term outcome].
abstract: 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.
authors.affiliation: Medizinische Abteilung, Ludwig-Boltzmann-Institut für Arrhythmieforschung, Wilhelminenspital der Stadt Wein, Osterreich.
authors.forename: C
authors.initials: C
authors.lastname: Hief
authors.forename: A
authors.initials: A
authors.lastname: Podczeck
authors.forename: K
authors.initials: K
authors.lastname: Frohner
authors.forename: M
authors.initials: M
authors.lastname: Nürnberg
authors.forename: F
authors.initials: F
authors.lastname: Veit
authors.forename: K
authors.initials: K
authors.lastname: Steinbach
mesh_terms: 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*