Complications leading to surgical revision in implantable cardioverter defibrillator patients: Comparison of patients with single-chamber, dual-chamber, and biventricular devices

G. Duray, Joern Schmitt, Sule Cicek-Hartvig, Stefan H. Hohnloser, Carsten W. Israel

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Aims: Implantable cardioverter defibrillator (ICD) technology has become more complex, particularly with respect to biventricular resynchronization devices. The incidence of hardware-related complications in single (SC)-, dual (DC)-, and triple (BiV)-chamber devices requiring surgical revision has not been investigated systematically. Methods and results: We analysed data from consecutive ICD recipients implanted between January 2000 and December 2007 with respect to the need of surgical re-intervention for device- or lead-related complications. Generator exchanges due to normal battery depletion were not considered. From 816 patients (81% male, 69% ischaemic cardiomyopathy, 48% secondary prevention ICDs) followed for 31 ± 24 months (2118 cumulative patient-years), 98 patients underwent 110 revisions (5.2% per patient-year). Complications included lead-related revision procedures in 81 cases and generator-related problems in 29 cases. The annual incidence of surgical revision due to complications was 11.8% in BiV compared with 4.9% in SC and 4.1% in DC patients (P = 0.002). This higher revision rate was mainly caused by lead-related complications. Implantation of a BiV system was an independent risk factor of the need for surgical revision (relative risk 2.37, 95% confidence interval 1.38-4.04). Conclusion: Even with long-lasting operator experience, complications requiring surgical revision remain a clinically important problem of ICD therapy. The incidence of complications is significantly higher in BiV resynchronization devices than in SC and DC systems.

Original languageEnglish
Pages (from-to)297-302
Number of pages6
JournalEuropace
Volume11
Issue number3
DOIs
Publication statusPublished - Mar 2009

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Implantable Defibrillators
Reoperation
Equipment and Supplies
Incidence
Secondary Prevention
Cardiomyopathies
Confidence Intervals
Technology
Lead

Keywords

  • Cardiac resynchronization therapy
  • Complications
  • Implantable defibrillator
  • Lead complication
  • Surgical revision

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Complications leading to surgical revision in implantable cardioverter defibrillator patients : Comparison of patients with single-chamber, dual-chamber, and biventricular devices. / Duray, G.; Schmitt, Joern; Cicek-Hartvig, Sule; Hohnloser, Stefan H.; Israel, Carsten W.

In: Europace, Vol. 11, No. 3, 03.2009, p. 297-302.

Research output: Contribution to journalArticle

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abstract = "Aims: Implantable cardioverter defibrillator (ICD) technology has become more complex, particularly with respect to biventricular resynchronization devices. The incidence of hardware-related complications in single (SC)-, dual (DC)-, and triple (BiV)-chamber devices requiring surgical revision has not been investigated systematically. Methods and results: We analysed data from consecutive ICD recipients implanted between January 2000 and December 2007 with respect to the need of surgical re-intervention for device- or lead-related complications. Generator exchanges due to normal battery depletion were not considered. From 816 patients (81{\%} male, 69{\%} ischaemic cardiomyopathy, 48{\%} secondary prevention ICDs) followed for 31 ± 24 months (2118 cumulative patient-years), 98 patients underwent 110 revisions (5.2{\%} per patient-year). Complications included lead-related revision procedures in 81 cases and generator-related problems in 29 cases. The annual incidence of surgical revision due to complications was 11.8{\%} in BiV compared with 4.9{\%} in SC and 4.1{\%} in DC patients (P = 0.002). This higher revision rate was mainly caused by lead-related complications. Implantation of a BiV system was an independent risk factor of the need for surgical revision (relative risk 2.37, 95{\%} confidence interval 1.38-4.04). Conclusion: Even with long-lasting operator experience, complications requiring surgical revision remain a clinically important problem of ICD therapy. The incidence of complications is significantly higher in BiV resynchronization devices than in SC and DC systems.",
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