Lead- and device-related complications in the antiarrhythmics versus implantable defibrillators trial

Jack Kron, John Herre, Ellen Graham Renfroe, Carlos Rizo-Patron, Merritt Raitt, Blair Halperin, Michael Gold, Bruce Goldner, Mark Wathen, Bruce Wilkoff, Anna Olarte, Qing Yao

Research output: Contribution to journalArticle

128 Scopus citations

Abstract

Background: Implantation of transvenous implantable cardioverter defibrillators (ICDs) by use of a nonthoracotomy approach has become routine therapy for survivors of life-threatening tachyarrhythmias. The purpose of this study was to identify and prospectively characterize the frequency of lead- and ICD-related complications from the Antiarrhythmics versus Implantable Defibrillators (AVID) Trial. Methods and Results: Between June 1, 1993, and April 7, 1997, 539 patients received nonthoracotomy ICDs either as initial treatment assignment (477) or as crossover from medical management (62). A total of 62 first complications occurred. The subclavian route of insertion resulted in more complications than the cephalic vein route, 46 of 339 (14%) versus 6 of 135 (4%), P = .005, as did the abdominal versus pectoral generator site, 31 of 238 (13%) versus 17 of 291 (6%), P < .02. Most dislodgements and system infections tended to occur in the 3 months after implantation, whereas lead fractures continued to occur throughout follow-up. Failure to use perioperative antibiotics was a predictor of system infection (P = .001). Conclusions: These data suggest that cephalic vein access and pectoral generator site may result in fewer complications. The continued occurrence of lead fractures and the need for premature system revision supports the practice of close routine ICD system surveillance.

Original languageEnglish (US)
Pages (from-to)92-98
Number of pages7
JournalAmerican heart journal
Volume141
Issue number1
DOIs
StatePublished - Jan 1 2001

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Kron, J., Herre, J., Renfroe, E. G., Rizo-Patron, C., Raitt, M., Halperin, B., Gold, M., Goldner, B., Wathen, M., Wilkoff, B., Olarte, A., & Yao, Q. (2001). Lead- and device-related complications in the antiarrhythmics versus implantable defibrillators trial. American heart journal, 141(1), 92-98. https://doi.org/10.1067/mhj.2001.111261