Implantable Cardioverter Defibrillators
Ahmad M. Zaki Radhi Nasir, Ravinder Batra, Rohan Jayasinghe
Abstract
Background
ICD/BVP indications are expanding. They are expensive devices and historically, morbidities associated with their use were high. The starting experience at the Gold Coast Hospital is being reviewed.
Methods
A retrospective chart review of all the ICD/BVPs implanted in the Gold Coast Hospital from June 2007 to June 2008, with special emphasis on device indications and complications.
Results
Devices implanted were (31). Primary prevention devices (67 per cent), secondary prevention devices (33 per cent). Indications were: Non-ischemic Dilated Cardiomyopathy (35 per cent), Out-of-hospital Cardiac Arrest (26 per cent), Conscious VT (13 per cent), Ischemic Dilated Cardiomyopathy (10 per cent), In-hospital Cardiac Arrest (6 per cent), Long-QT Syndrome (6%) and Catecholamine-related Polymorphic VT (3 per cent). Major complications reported; lung contusion (1), left hemothorax (1), failed coronary sinus lead positioning (2), lead re-positioning (2), atrial lead removal (1), left subclavian vein thrombosis (1), lead malfunction leading to VT under sensing and syncope (1). Device-administered therapies were eight; Inappropriate discharges (5), Appropriate discharges (1), successful Anti-tachycardia Pacing (2).
Conclusions
We believe that ICDs are very effective life-saving devices but unfortunately they still are very expensive and their use can be associated with significant morbidities especially during the learning curve.
Full Text:
ICD/BVP indications are expanding. They are expensive devices and historically, morbidities associated with their use were high. The starting experience at the Gold Coast Hospital is being reviewed.
Methods
A retrospective chart review of all the ICD/BVPs implanted in the Gold Coast Hospital from June 2007 to June 2008, with special emphasis on device indications and complications.
Results
Devices implanted were (31). Primary prevention devices (67 per cent), secondary prevention devices (33 per cent). Indications were: Non-ischemic Dilated Cardiomyopathy (35 per cent), Out-of-hospital Cardiac Arrest (26 per cent), Conscious VT (13 per cent), Ischemic Dilated Cardiomyopathy (10 per cent), In-hospital Cardiac Arrest (6 per cent), Long-QT Syndrome (6%) and Catecholamine-related Polymorphic VT (3 per cent). Major complications reported; lung contusion (1), left hemothorax (1), failed coronary sinus lead positioning (2), lead re-positioning (2), atrial lead removal (1), left subclavian vein thrombosis (1), lead malfunction leading to VT under sensing and syncope (1). Device-administered therapies were eight; Inappropriate discharges (5), Appropriate discharges (1), successful Anti-tachycardia Pacing (2).
Conclusions
We believe that ICDs are very effective life-saving devices but unfortunately they still are very expensive and their use can be associated with significant morbidities especially during the learning curve.
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