Problems with implantable cardiac device therapy.
Implantable cardioverter-defibrillators (ICDs) improve survival in patients who have left ventricular dysfunction; however, they are associated with numerous problems at implant and during follow-up. The diagnosis and management of these problems is usually straightforward, but more difficult problems may include the management of patients who have elevated energy requirements to terminate ventricular fibrillation or of those who have postoperative device infections. Long-term issues in ICD patients include the occurrence of inappropriate or frequent appropriate shocks. ICD generators and leads are more prone to failures than are pacing systems alone; management of patients potentially dependent on "recalled" devices to deliver life-saving therapy is a particularly complex issue. The purpose of this article is to review the diagnosis and management of these more troublesome ICD problems.
Kowalski
Marcin
M
Department of Cardiac Electrophysiology Service, Virginia Commonwealth University Medical Center, Richmond, VA 23298-0053, USA.
Huizar
Jose F
JF
Kaszala
Karoly
K
Wood
Mark A
MA
D000465:Algorithms; D017147:Defibrillators, Implantable; D004567:Electrodes, Implanted; D006801:Humans; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D012307:Risk Factors; D014693:Ventricular Fibrillation