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Updated: Aug 15, 2026
A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
[Sub-pectoral implantation of defibrillators: intraoperative data and long-term outcome]
C Hief1, A Podczeck, K Frohner
1Medizinische Abteilung, Ludwig-Boltzmann-Institut für Arrhythmieforschung, Wilhelminenspital der Stadt Wein, Osterreich.
Insights
This study evaluated implantable cardioverter-defibrillator (ICD) systems, finding low perioperative risks and lead complications. Regular patient monitoring is crucial despite technical advancements in ICD lead systems.
Area of Science:
- Cardiology
- Medical Devices
- Surgical Procedures
Background:
- Implantable cardioverter-defibrillators (ICDs) are vital for managing life-threatening arrhythmias.
- Advancements in lead systems and device size facilitate less invasive implantation techniques.
Purpose of the Study:
- To assess perioperative mortality, morbidity, and lead-related complications in patients receiving ICDs with transvenous leads and subpectoral generator placement.
- To evaluate the safety and efficacy of modern ICD implantation procedures.
Main Methods:
- A cohort of 57 consecutive patients undergoing ICD implantation with transvenous leads and subpectoral generator placement was studied.
- Perioperative outcomes, defibrillation thresholds, and long-term lead-related complications were meticulously recorded.
Main Results:
- The study included 54 patients with transvenous lead systems; 95% achieved adequate defibrillation thresholds.
- Perioperative complications occurred in 7% of patients (n=4), with no surgical intervention required.
- Lead-related complications were observed in 5.5% of patients (n=3) during a mean follow-up of 27 months; no late mortality was reported.
Conclusions:
- Subpectoral ICD generator implantation with transvenous leads is a safe and effective procedure with low complication rates.
- Despite technological progress, vigilance for lead system complications and the necessity for regular patient follow-up remain critical.
Unlabelled:
The present study examined the perioperative mortality and morbidity and lead-related complications in patients who had a defibrillator with a transvenous lead system and subpectoral implantation of the generator. Fifty-four out of 57 consecutive patients (95%) received a transvenous lead system. One patient had an acceptable defibrillation threshold with an additional subcutaneous patch whereas no sufficient defibrillation threshold was found in another 2 patients. Two patients died due to congestive heart failure after implantation. Perioperative complications were observed in 4 patients (7%) including pericardial effusion, pocket hematoma, injury of the plexus brachialis and a pneumothorax. None of these complications required surgical intervention. Fifty-five patients were discharged from the hospital. During 27 +/- 10 months none of these patients died. Lead-related complications were observed in 3 patients (5.5%) including microdislocation in two and a outer conductor fracture in one of the lead.
Conclusion:
Technical advancement such as a non-thoracotomy lead system and smaller devices have made the onc-incision approach and subpectoral implantation of the ICD generator clinical routine. Nevertheless complications related to the lead system can occur. Therefore frequent controls of patients with ICD are necessary.
