open access

Vol 65, No 8 (2007)
Other
Published online: 2007-08-29
Submitted: 2012-12-28
Get Citation

Original article
Causes of redo procedures in patients with an implantable cardioverter-defibrillator – long-term follow-up results

Katarzyna Gepner, Andrzej Przybylski, Aleksander Maciąg, Maciej Sterliński, Michał Lewandowski, Paweł Syska, Ilona Kowalik, Hanna Szwed
Kardiol Pol 2007;65(8):893-898.

open access

Vol 65, No 8 (2007)
Other
Published online: 2007-08-29
Submitted: 2012-12-28

Abstract

Background: Implantation of a cardioverter-defibrillator (ICD) is a well-established method to prevent sudden cardiac death (SCD). Due to the expanding indications for this type of treatment and increasing survival of these patients, the ICD population is growing rapidly.
Aim: To assess the rate and causes of reoperations in patients with ICD over a long-term (at least 4 years) follow-up period.
Methods: Between 1995 and 2006, an ICD was implanted in 598 patients. This study included all patients with a follow-up duration of at least 4 years and only those who underwent a repeat procedure later than 6 weeks after the index ICD implantation.
Results: The study group consisted of 174 patients with a mean age of 51±18 years who were followed for a mean of 6±1.7 years. Coronary artery disease (CAD) was diagnosed in 92 (53%) patients, and non-ischaemic cardiomyopathy in 82 (47%) patients. Prophylactic ICD therapy was instituted in 11 (6%) patients, whereas 163 (94%) patients received ICD for secondary prophylactics. During the follow-up period, 10 deaths occurred: 6 of all deaths (60%) in patients with CAD and 4 of all deaths (40%) in the non--ischaemic group. A total of 211 redo procedures in 139 patients were performed. Indications for repeat procedures included battery depletion in 136 patients, ICD malfunction in 37 cases, infection related to the implanted system in 5 patients, problems with leads in 19 cases, an upgrade to the dual-chamber system in 5 or to the biventricular system in 3 patients, and the revision of an ICD pocket in 6 patients.
Conclusions: Repeat procedures in ICD recipients are frequent. The most common cause is battery depletion and ICD replacement indicated by a manufacturer. Improvement in ICD technology is essential to increase ICD longevity and decrease the redo-procedure rates. Patients with ICD should be regularly followed in experienced centres in order to detect ICD system failure early.

Abstract

Background: Implantation of a cardioverter-defibrillator (ICD) is a well-established method to prevent sudden cardiac death (SCD). Due to the expanding indications for this type of treatment and increasing survival of these patients, the ICD population is growing rapidly.
Aim: To assess the rate and causes of reoperations in patients with ICD over a long-term (at least 4 years) follow-up period.
Methods: Between 1995 and 2006, an ICD was implanted in 598 patients. This study included all patients with a follow-up duration of at least 4 years and only those who underwent a repeat procedure later than 6 weeks after the index ICD implantation.
Results: The study group consisted of 174 patients with a mean age of 51±18 years who were followed for a mean of 6±1.7 years. Coronary artery disease (CAD) was diagnosed in 92 (53%) patients, and non-ischaemic cardiomyopathy in 82 (47%) patients. Prophylactic ICD therapy was instituted in 11 (6%) patients, whereas 163 (94%) patients received ICD for secondary prophylactics. During the follow-up period, 10 deaths occurred: 6 of all deaths (60%) in patients with CAD and 4 of all deaths (40%) in the non--ischaemic group. A total of 211 redo procedures in 139 patients were performed. Indications for repeat procedures included battery depletion in 136 patients, ICD malfunction in 37 cases, infection related to the implanted system in 5 patients, problems with leads in 19 cases, an upgrade to the dual-chamber system in 5 or to the biventricular system in 3 patients, and the revision of an ICD pocket in 6 patients.
Conclusions: Repeat procedures in ICD recipients are frequent. The most common cause is battery depletion and ICD replacement indicated by a manufacturer. Improvement in ICD technology is essential to increase ICD longevity and decrease the redo-procedure rates. Patients with ICD should be regularly followed in experienced centres in order to detect ICD system failure early.
Get Citation

Keywords

implantable cardioverter-defibrillator (ICD); complications; repeat procedures

About this article
Title

Original article
Causes of redo procedures in patients with an implantable cardioverter-defibrillator – long-term follow-up results

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 65, No 8 (2007)

Pages

893-898

Published online

2007-08-29

Bibliographic record

Kardiol Pol 2007;65(8):893-898.

Keywords

implantable cardioverter-defibrillator (ICD)
complications
repeat procedures

Authors

Katarzyna Gepner
Andrzej Przybylski
Aleksander Maciąg
Maciej Sterliński
Michał Lewandowski
Paweł Syska
Ilona Kowalik
Hanna Szwed

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., Świętokrzyska 73 street, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl