Which factors increase the risk of acute complications from placement of an implantable cardioverter-defibrillator (ICD)?

Updated: Oct 11, 2019
  • Author: Daniel M Beyerbach, MD, PhD; Chief Editor: Jeffrey N Rottman, MD  more...
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Answer

Answer

The indication for ICD implantation represents a balance between potential benefit and likely risk. The acute risk of ICD implantation is small but is increased by multiple factors. The following are risk factors established by an ICD registry risk score model: [63]

  • Age greater than 70 years - 1 point

  • Female - 2 points

  • New York Heart Association (NYHA) class III - 1 point

  • NYHA class IV - 3 points

  • Atrial fibrillation - 1 point

  • Prior valve surgery - 3 points

  • Chronic lung disease - 2 points

  • Blood urea nitrogen (BUN) > 30 mg/dL - 2 points

  • Reimplantation for reasons other than battery change - 6 points

  • Dual chamber ICD type - 2 points

  • Biventricular ICD type - 4 points

  • Nonelective ICD implant -3 points

The risk of any inhospital complication increases from 0.6% among patients with a score of less than 5 to 8.4% among the patients with greater than 19 risk points.


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