INFECTION OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR SYSTEMS - A PREVENTABLE COMPLICATION

In a consecutive series of 164 patients undergoing primary implantatio n of an implantable cardioverter defibrillator (ICD), two patients die d in the hospital (1.2%) and early system infection developed in one p atient requiring explantation of the device (0.61%). Late infection de veloped in one additional patient (0.61%) 7 months after transvenous I CD implantation, and was thought to be due to a recent intravascular c atheterization. Symptomatic generator pocket hematomas developed in th ree patients, two of which were treated by simple evacuation and one w ith temporary generator explantation and subsequent reimplantation of the unit in a new pocket. No infection developed in these three patien ts during follow-up. Generator erosion without obvious system infectio n developed in a fourth patient. Guidelines for the prevention of infe ction in ICD systems are presented.