Outcome of advisory implantable cardioverter-defibrillator replacement: One-year follow-up

Gould, Paul A., Guta, Lorne J., Champagne, Jean, Healyey, Jeffrey S., Cameron, Doug, Simpson, Christophers, Thibault, Bernard, Pinter, Arnold, Tung, Stanley, Sterns, Laurence, Birnie, David, Exner, Derek, Parkash, Ratika, Skanes, Allan C., Yee, Raymond, Klein, George J. and Krahn, Andrew D. (2008) Outcome of advisory implantable cardioverter-defibrillator replacement: One-year follow-up. Heart Rhythm, 5 12: 1675-1681. doi:10.1016/j.hrthm.2008.09.020

Author Gould, Paul A.
Guta, Lorne J.
Champagne, Jean
Healyey, Jeffrey S.
Cameron, Doug
Simpson, Christophers
Thibault, Bernard
Pinter, Arnold
Tung, Stanley
Sterns, Laurence
Birnie, David
Exner, Derek
Parkash, Ratika
Skanes, Allan C.
Yee, Raymond
Klein, George J.
Krahn, Andrew D.
Title Outcome of advisory implantable cardioverter-defibrillator replacement: One-year follow-up
Journal name Heart Rhythm   Check publisher's open access policy
ISSN 1547-5271
Publication date 2008-12-01
Year available 2008
Sub-type Article (original research)
DOI 10.1016/j.hrthm.2008.09.020
Open Access Status Not Open Access
Volume 5
Issue 12
Start page 1675
End page 1681
Total pages 7
Place of publication Philadelphia, PA United States
Publisher Elsevier Inc.
Language eng
Formatted abstract
Implantable cardioverter defibrillator (ICD) generator advisories present management dilemmas for physicians regarding competing risks of ICD failure and replacement-related complications. There is currently a paucity of long-term data concerning the complications associated with advisory ICD replacement.

In a large multicenter advisory ICD generator replacement cohort followed for 12 months, we aimed to assess replacement-related complications by performing a case-control determination of complication risk factors to identify characteristics that could assist with advisory ICD replacement decision making.

Twelve large ICD implanting centers reviewed the 1-year follow-up outcome of advisory ICDs replaced between October 2004 and October 2005. The complication cohort was characterized and compared in a nested case-control analysis with age- and gender-matched controls without complications from the same replacement population.

At the 12 participating institutions, 451 of 2635 advisory ICD devices were replaced (17.1%). Over 355 ± 204 days of follow-up, there were 41 (9.1%) complications; 27 (5.9%) required reoperation and included two deaths. There were 14 minor complications (3.1%). Multivariate analysis demonstrated that the number of previous pocket procedures was associated with an increase in complications and that combined consultant and fellow operators was associated with a decrease in complications compared with a single operator alone.

Complications from advisory ICD generator replacement are frequent and include infection and, rarely, death. The risk of replacement is increased in patients with multiple previous pocket procedure 
Keyword Implantable cardioverter defibrillator
Risk factors
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 39 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 51 times in Scopus Article | Citations
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