What is the prevalence of acute surgical complications in implantable cardioverter-defibrillators (ICDs) and which factors increase the risk?

Updated: Oct 11, 2019
  • Author: Daniel M Beyerbach, MD, PhD; Chief Editor: Jeffrey N Rottman, MD  more...
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An analysis of more than 350,000 ICD implantations included in the National Cardiovascular Data Registry–ICD Registry revealed 3.1% of patients experienced inhospital adverse events, 1.2% experienced major adverse events, and 0.4% died. Adverse events were lower (1.9%) with single-chamber ICD implants than with dual-chamber ICD implants (2.9%) or with biventricular ICD implants (4.1%). Specific adverse event rates included lead dislodgement (1%), hematoma (0.9%), pneumothorax (0.4%), and cardiac arrest (0.3%).

Physician level of training and level of specialty certification have been shown to affect the risk of adverse events associated with ICD implant. An ICD Registry analysis found that physicians who implant more ICDs have lower rates of procedural complications and in-hospital mortality [47] Implant volume may partially explain the difference in adverse events among physicians with different specialty certifications. However, no inverse relationship was found between procedure volume and adverse event rate observed within the board certified category.

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