Cardioverter-defibrillator systems implanted without thoracotomy: radiographic findings

Ventricular arrhythmias are the primary cause of sudden death from heart disease in the United States. In the past decade, management of these arrhythmias has been revolutionized by the development of implantable cardioverter-defibrillators (ICDs). Earlier devices required thoracotomy for implantation (Fig. 1). Complications associated with the earlier devices include pneumothorax, pleural effusion, mediastinal infection, and, notably, crinkling of the patch and migration. The morbidity of median sternotomy has led to the development of ICDs that can be implanted without thoracotomy. We illustrate the normal radiographic appearance and complications of two recently developed ICD lead systems.