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Multiple ICD Replacements Can Predict Complications
Date:12/11/2008

Those with history of repeat surgeries likely to face infection, bleeding, study finds

THURSDAY, Dec. 11 (HealthDay News) -- Patients with implantable cardioverter defibrillators (ICDs) who've had multiple, previous pocket procedures have an increased risk of suffering complications after ICD replacement, according to a study that included the 12 largest ICD implanting centers in Canada.

Dr. Andrew Krahn, of the London Health Sciences Center in Ontario, and colleagues also found a higher-than-expected overall ICD replacement complication rate than previous studies.

The Canadian study included 451 patients who had ICD devices replaced between October 2004 and October 2005 and were monitored for major and minor complications. Major complications include serious infection requiring removal of the ICD, bleeding, or ICD malfunction. Minor complications include minor infection and worsening of other medical conditions.

After one year of follow-up, 41 (9.1 percent) of the patients experienced complications, 27 (5.9 percent) required additional surgery, and two patients died. Fourteen patients (3.1 percent) experienced minor complications.

The study, published in the December issue of HeartRhythm Journal, proves that multiple, previous pocket procedures are a predictor of ICD replacement complications, the researchers said.

"No prior research has investigated the potential risk factors associated with ICD replacement, more specifically, what makes some patients more at-risk than others," Krahn said in a Heart Rhythm Society news release. "Study findings will help physicians better understand complication risks for patients who may need ICD replacement, and ultimately, provide better care for their patients."

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