[Lead-related complications in 340 patients with an implantable cardiverter/defibrillator].
From February 1991 to May 1998, 340 patients had a cardioverter/defibrillator (ICD) implanted. Mean age was 64 +/- 9 years, 278 male and 62 female. 60% of patients had coronary artery disease and 31% dilatative cardiomyopathy. Ejection fraction was 38 +/- 14%. The indication for an implantable cardioverter/defibrillator was in 57% of patients ventricular tachycardia, in 43% ventricular fibrillation. 298 patients had a single-chamber cardioverter/defibrillator implanted, 42 patients a dual-chamber cardioverter/defibrillator. In 25 patients additional subcutaneous patch or array electrodes and in 2 patients additional epicardial patch electrodes were implanted. Implantation site was in 92 patients abdominal and in 248 pectoral. Over a period of 7 years 34 lead-related complications occurred in 33 patients (9.7%), after a median of 2 months after implantation. Diagnosis was made by routine chest x-ray in about 55% of lead-related complications, by clinical presentation (inadequate therapy, pain) in 24%, and by electrical parameters in 21%. In patients with an abdominal implantation site, lead-related complications occurred in 20%, in contrast to 6% in patients with a pectoral implantation site. Regarding patients with pectoral implantation site, lead-related complications were observed in 12% of patients with a dual-chamber ICD vs 4% with a single-chamber ICD (p = 0.05), due to dislocation of atrial electrodes with dual-chamber ICD. There were no differences in clinical parameters between patients with pectoral vs abdominal and between single vs dual-chamber ICD. There were no deaths due to lead-related complications.
Schwacke
H
H
Herzzentrum Ludwigshafen, Medizinische Klinik B, Bremserstr. 79, D-67063 Ludwigshafen, Germany.
Drögemüller
A
A
Siemon
G
G
Werling
C
C
Saggau
W
W
Senges
J
J
Seidl
K
K
D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000628:therapy*; D003327:Coronary Disease / Q000628:therapy*; D017147:Defibrillators, Implantable; D004567:Electrodes, Implanted; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000628:therapy*; D014693:Ventricular Fibrillation / Q000628:therapy*