High incidence of device-related and lead-related complications in the dual-chamber implantable cardioverter defibrillator compared with the single-chamber version.
Recently, the routine use of dual-chamber implantable cardioverter defibrillators (DC-ICD) has been advocated over the single-chamber version (SC-ICD), but there are few reports of the frequency of complications between the 2 types of ICDs. Between July 1997 and April 1999, 178 consecutive patients underwent implantation of either a transvenous SC-ICDs (n=104) or a DC-ICDs (n=74). Twelve (16%) of the 74 patients with a DC-ICD had a total of 16 major complications compared with 6 (6%) of the 104 patients with a SC-ICD (p=0.01). The 16 DC-ICD complications included atrial lead dislodgment (4), ventricular lead malfunction (4), and pocket infection/hematoma (3), and the 6 SC-ICD complications included ventricular lead dislodgment (2) and pocket hematoma (3). Patients with a DC-ICD had less left ventricular function (29% vs 35%, p=0.035) and a higher prevalence of non-ischemic cardiomyopathies (48% vs 28%, p=0.0076). In conclusion, the DC-ICD may have a higher frequency of device- and lead-related major complications.
Department of Cardiology, Good Samaritan Hospital, Los Angeles, California 90017, USA.
Tamana
T
Takahashi
Anil K
AK
Bhandari
Masato
M
Watanuki
David S
DS
Cannom
Harumizu
H
Sakurada
Masayasu
M
Hiraoka
D000368:Aged; D009202:Cardiomyopathies / Q000453:epidemiology / Q000209:etiology; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000453:epidemiology / Q000209:etiology; D006406:Hematoma / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D007239:Infections / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology / Q000209:etiology