[Sub-pectoral implantation of defibrillators: intraoperative data and long-term outcome].

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.