Complications in recipients of cardioverter--defibrillator or cardiac resynchronization therapy: Insights from Silesian center defibrillator registry

Abstract

Background: Current real-life information from all-comers registries from middle and east Europe about the incidence and type of complications during long-term follow-up of patients with cardioverters-defibrillators (ICD) and cardiac resynchronization devices-defibrillators (CRT-D) is still insufficient. The aim of the study was to assess the incidence and determinants of short- and long-term complications related to implantable ICD and CRT-D. Methods: We studied 1,105 recipients hospitalized in our center in 2009–2013, followed for a mean of 2.4 years (total of 2,652 patient-years). The independent association between ICD and CRT-D recipi-ents’ and implantation-procedures’ characteristics with the incidence of complications was analyzed using multivariable Cox regression analysis. Results: In 2-month post-procedural period, 124 (11.2%) patients developed complications. Independent predictors of short-term complications (within 2 months) were: atrial fibrillation, dual chamber ICD implantation, and use of antiplatelet therapy or coumarin. Twenty-seven (2.44%) patients experienced complications, mostly lead-related (n = 21). Independent predictors of long-term complications (2–12 months after implantation) were atrial fibrillation and dual chamber ICD implantation. Conclusions: Despite significant technological progress and operators’ experience, the occurrence of complications in ICD and CRT-D recipients is still substantial. Majority of complications are recorded in the early post-implantation phase. Analysis of independent predictors of complications seem to be essential in helping to reduce adverse events in the future and strongly supports the need for routine follow-up.