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[Good experiences with an implantable automatic defibrillator with transvenous electrodes for patients with
E R Jessurun1, B A Hutten, N M van Hemel
1St.-Antonius Ziekenhuis, afd. Cardiologie, Nieuwegein.
Objective:
To describe the results of treatment of patients with a life-threatening arrhythmia by implantation of an second generation implantable cardioverter defibrillator with transvenous electrodes.
Design:
Descriptive.
Setting:
St.-Antonius Hospital, Nieuwegein, the Netherlands.
Method:
In the period October 1991-February 1996 the ICD with transvenous electrodes was implanted in 44 patients. After a year the quality of life was assessed by written questionnaire.
Results:
The in-hospital mortality was 1/44 (2%), without peroperative death. During follow-up 4 patients died: 3 due to congestive heart failure and 1 due to sudden cardiac death. Within one year 50% of the patients had a therapeutical ICD discharge. In 30/44 (68%) patients antiarrhythmic drugs were prescribed to reduce the number of ICD discharges or because they were suffering from paroxysmal atrial fibrillation with high heart rates, which could result in an inappropriate ICD discharge. Quality of life analysis showed a good acceptance of the ICD, although 86% of the patients considered it a very serious limitation that they were not allowed to drive a motor vehicle anymore.
Conclusion:
The ICD constitutes a major step forward in the treatment of life-threatening ventricular arrhythmias because the implantation is easier and follow-up shows adequate antiarrhythmic effects and survival.