THE IMPLANTABLE PACEMAKER-CARDIOVERTER-DEFIBRILLATOR - RADIOGRAPHIC ASPECTS

Safer and easier placement, recent approval by the U.S. Food and Drug Administration of several models, and increasing availability have exp anded the use of implantable cardioverter-defibrillators (ICDs) for tr eatment of life-threatening ventricular tachyarrhythmia. Modern ICDs g enerally use a combination of two transvenously placed electrodes and one subcutaneous electrode; therefore, they do not require a thoracoto my for placement. The authors evaluated the radiographic aspects of on e particular ICD-the pacemaker-cardioverter-defibrillator (PCD)-includ ing the normal appearance and variations, confusing findings, and such complications as deformity of the subcutaneous patch electrode, lead fracture, and electrode malposition and migration. The PCD can also be combined with a preexisting, surgically placed automatic ICD or with a pacemaker. Familiarity with the PCD and other ICDs is essential, sin ce the radiologist may be the first to recognize a complication that c an render the device inoperative and leave the patient vulnerable to s udden death.