TRANSVENOUS VERSUS TRANSTHORACIC CARDIOVERTER-DEFIBRILLATOR IMPLANTATION - A COMPARATIVE-ANALYSIS OF MORBIDITY, MORTALITY, AND SURVIVAL

The hypothesis that transvenous implantation of a cardioverter-defibri llator is associated with less morbidity than use of a transthoracic a pproach was investigated in a retrospective series of 146 patients, No ne of these patients had concomitant heart procedures, and the preoper ative characteristics of the two groups were similar. When analyzed by actual technique used (transvenous, 57 patients; transthoracic, 89 pa tients) and by the intention-to-treat method (transvenous, 65 patients , 8 of whom actually underwent thoracotomy; thoracotomy, 81 patients), transvenous implantation was associated with a lower incidence of pos toperative respiratory complications and atrial fibrillation. Total ca rdiac mortality and freedom from sudden cardiac death in the transveno us and transthoracic groups were comparable at 2 years.