Implantation-Related Complications of Implantable Cardioverter-Defibrillators and Cardiac Resynchronization Therapy Devices

Abstract

The number of implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy (CRT) implantations is increasing drastically worldwide, and hence, the number of implanting centers is also increasing. Despite abundant data on the beneficial effect of these devices, little is known regarding safety and complication rates. Eleven ICD and 7 CRT trials were systematically reviewed to provide data on the frequency of in-hospital mortality and complications related to the implantation. Average in-hospital mortality was 2.7% in trials using both thoracotomy and nonthoracotomy ICDs, 0.2% in trials using nonthoracotomy ICDs, and 0.3% in CRT trials. The pneumothorax rate was similar between the nonthoracotomy ICD and CRT trials (0.9%) Coronary sinus complications occurred in 2.0% of patients undergoing CRT. Lead dislodgement rates were higher in CRT trials (5.7%) than in nonthoracotomy ICD trials (1.8%).

Cardiac Contractility Modulation Device and Subcutaneous Implantable Cardioverter Defibrillator Combination: A New Hope for Heart Failure Patients with Low Ejection Fraction and Narrow QRS Complex

“…The transvenous ICD reduced the morbidity and risk associated with thoracotomy implants. However, use of transvenous leads involves potential complications which may happen acutely such as lead dislodgement, pneumothorax, hemopericardium, cardiac perforation, pericardial effusion, and cardiac tamponade, or chronically such as devicerelated infection, lead malfunction, inappropriate shocks, and venous occlusion [37][38][39][40][41].…”

Emergencies of Implantable Cardioverter Defibrillator

“…Mechanical complications are related to implantation procedure such as pneumothorax, hemothorax, subclavian artery puncture, thrombosis, pocket hematoma, infection, lead dislodgement, and myocardial perforation [3,13,14].…”

Combined vascular and neurologic injury after cephalic vein cutdown approach for ICD implantation

“…[1][2][3][4][5] Subclavian artery injury is a well known and widely reported complication of device implantation; [6] however, combined subclavian artery and subclavian vein injury during cephalic vein cut down and pocket formation is not well reported. We report two cases detailing the mechanism of subclavian artery and vein injury during cephalic vein cut down in the first case and during blunt dissection of the pocket in the second case.…”