A. Podczeck et al., COMPLICATIONS WITH THE IMPLANTABLE CARDIO VERTER-DEFIBRILLATOR USING THE TRANSVENOUS-SUBCUTANEOUS APPROACH, Zeitschrift fur Kardiologie, 83(5), 1994, pp. 366-372
Due to technical improvement using the transvenous-subcutaneous approa
ch for lead fixation for cardioverter-defibrillator implantation, the
incidence of device implantation has extended enormously. While a sign
ificant lower perioperative mortality in transvenously implanted syste
ms compared to epicardially fixed implantable cardioverter-defibrillat
or (ICD) has been proven, perioperative as well as complications durin
g follow-up are not analyzed systematically. In 59 patients, in whom t
ransvenous-subcutaneous ICDs had been implanted, 3 patients showed ble
eding complications in the subcutaneous patch area, 1 patient showed a
bleeding in the device pocket, and in 1 patient a seroma in the subcu
taneous patch region was observed necessitating surgical revisions. Du
ring follow-up of 10 +/- 7 months, lead dislocations were observed in
6 patients, in another 6 patients patch crinkling was observed. There
was 1 patient with a lead fracture as well as 1 patient with a bleedin
g in the subcutaneous patch region. Despite the high efficacy of this
therapy used in patients with life-threatening ventricular arrhythmias
, these potential complications have to be considered.