title: Evaluating current implantable cardioverter defibrillator implantation procedures: can common complications be minimised?
abstract: The implantable cardioverter-defibrillator (ICD) is the cornerstone of treatment and prevention of malignant ventricular arrhythmias. Despite 30 years of experience, implantation of ICDs carries a risk of complications both during the procedure and long-term follow-up. Operator and procedure related factors may contribute to this risk. Furthermore, access, pocket, device and lead related problems occur, on top of problems related to arrhythmias and the patient themselves. Infection is the most feared complication, and its incidence seems to rise. Factors leading to complications are assessed, as well as measures to reduce these complications, including antibiotics and subcutaneous devices. Four patient categories with an increased risk are identified: the elderly with atrial fibrillation, diabetes or renal failure; the pediatric patient with or without congenital heart disease, the young patient with specific inherited diseases, and all those who undergo replacement, upgrade or concomitant lead extraction.
authors.affiliation: a Departments of Cardiology , Ghent University Hospital , Ghent , Belgium.
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Timmers
authors.affiliation: a Departments of Cardiology , Ghent University Hospital , Ghent , Belgium.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Van Heuverswyn
authors.affiliation: b Departments of Paediatrics , Ghent University Hospital , Ghent , Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: De Wilde
authors.affiliation: c Department of Internal Medicine , Ghent University , Ghent , Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Jordaens
mesh_terms: D001145:Arrhythmias, Cardiac / Q000628:therapy*; D002318:Cardiovascular Diseases / Q000150:complications; D017147:Defibrillators, Implantable / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D012307:Risk Factors
keywords: Sudden cardiac death; complication; dislocation; hematoma; implantable cardioverter defibrillator; infection