LONG-TERM SURVIVAL AND COMPLICATIONS IN PATIENTS WITH MALIGNANT VENTRICULAR TACHYARRHYTHMIAS - TREATMENT WITH A NONTHORACOTOMY IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR WITH OR WITHOUT A SUBCUTANEOUS PATCH

The Endotak lead system and ICD has been used to treat patients with m alignant ventricular arrhythmias. We analyzed the clinical characteris tics of 1,053 patients who underwent implantation of the Endotak lead system with or without a subcutaneous patch. Group A consisted of 567 patients receiving the Endotak lead with a subcutaneous patch; group B consisted of 486 patients receiving the Endotak lead alone. The 2-yea r survivals from sudden death, cardiac death, and total death in group s A and B were 97.6%/98.2% (P = 0.38), 88.6%/92.7% (P = 0.09), and 84. 7%/86.8% (P = 0.06), respectively. Minimum tested effective defibrilla tion energy at implantation was 17.2 +/- 5.2 J for group A and 15.8 +/ - 5.1 J for group B (P < 0.01). The operative mortality was 1.8% in gr oup A and 0.6% in group B (P = 0.09). The incidence of lead dislodgmen t, malfunction, and infection was 6.7% for group A and 3.5% for group B (P < 0.02), Sudden death survival was excellent in both groups with less lead complications in group B. The Endofak lead alone may be the preferred choice of lead configuration in those patients who have adeq uate defibrillation thresholds at implant.