[Problems and complications after implantation of automatic defibrillators].

Until now there are only few reports about problems and complications associated with the automatic implantable cardioverter-defibrillator (ICD). Therefore, we studied the follow-up of 295 patients, who underwent ICD therapy. Epicardial ICD implantation was performed in 206 patients (71%) and 89 patients (29%) received transvenous ICD systems. Infections or seroma of the pulse generator and/or lead systems were observed in 18 patients (6%), in nine patients after first ICD implant and in nine patients after generator replacement. General signs of inflammation were present in eleven patients, whereas local signs with seroma of the pocket were observed in seven patients. Explantation of the entire ICD hardware was performed in eleven patients and seven patients underwent partial removal of the ICD system. Lead complications occurred in 15 patients (5%), in eleven patients with epicardial and in four with transvenous ICD systems. All patients had inappropriate ICD shocks and had to undergo lead replacement. Inappropriate ICD shocks due to supraventricular tachyarrhythmias occurred in 24 patients (8%). Other complications (apoplexia, hematoma, pneumothorax) were observed in 15 patients (5%). Our data show that complications associated with the ICD are low. However, these complications can cause big problems and need appropriate diagnosis and treatment.