Implantable Cardioverter Defibrillators

Abstract

Background: ICD/BVP indications are expanding. They areexpensive devices and historically, morbidities associated withtheir use were high. The starting experience at the Gold CoastHospital is being reviewed.Methods: A retrospective chart review of all the ICD/BVPsimplanted in the Gold Coast Hospital from 06/07/2007 -17/06/2008, with special emphasis on device indications andcomplications.Results: Devices implanted were (31). Primary preventiondevices (67%), secondary prevention devices (33%).Indications were; Non-ischemic Dilated Cardiomyopathy(35%), Out-of-hospital Cardiac Arrest (26%), Conscious VT(13%), Ischemic Dilated Cardiomyopathy (10%), In-hospitalCardiac Arrest (6%), Long-QT Syndrome (6%) andCatecholamine-related Polymorphic VT (3%). Majorcomplications reported; lung contusion (1), left haemothorax(1), failed coronary sinus lead positioning (2), lead repositioning(2), atrial lead removal (1), left subclavian veinthrombosis (1), lead malfunction leading to VT under sensingand 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 lifesavingdevices but unfortunately they still are very expensiveand their use can be associated with significant morbiditiesespecially during the learning curve.