Transvenous and subcutaneous implantable cardioverter defibrillators: radiographic assessment.

PURPOSE

To assess chest radiograph configurations in 102 patients following total or partial transvenous and subcutaneous insertion of a non-thoracotomy lead implantable cardioverter defibrillator (NTL-ICD) device.

MATERIALS AND METHODS

The four overlapping system types reviewed were the Endotak (49 patients), PCD (32 patients), Res-Q (10 patients), and hybrid combinations of NTL-ICD and surgically inserted pericardial and epicardial automatic implantable cardioverter defibrillator (AICD) devices (15 patients).

RESULTS

Abnormalities were detected on radiographs both at the time of implantation and at early follow-up. NTL-ICD electrodes partially replaced or augmented AICD systems in 11 patients (10.7%) because of sensing lead or defibrillation failure or infection. Defibrillation failure necessitated augmentation of NTL-ICD systems with AICD pericardial patches in four patients (3.9%). Catheter displacement, lead fracture, or pneumothorax was detected in eight patients (7.8%).

CONCLUSION

Complex radiographic appearances may be seen and important abnormalities may be detected after insertion of these devices.