A clinical review of implantable cardioverter defibrillators and Bi-ventricular pacemakers at one institute

Background: ICD/BVP indications are expanding. They are expensive devices and historically, morbidities associated with their use were high. The starting experience at the Gold Coast Hospital is being reviewed. Methods: A retrospective chart review of all the ICD/BVPs implanted in the Gold Coast Hospital from 06/07/2007 - 17/06/2008, with special emphasis on device indications and complications. Results: Devices implanted were (31). Primary prevention devices (67%), secondary prevention devices (33%). Indications were; Non-ischemic Dilated Cardiomyopathy (35%), Out-of-hospital Cardiac Arrest (26%), Conscious VT (13%), Ischemic Dilated Cardiomyopathy (10%), In-hospital Cardiac Arrest (6%), Long-QT Syndrome (6%) and Catecholamine-related Polymorphic VT (3%). Major complications reported; lung contusion (1), left haemothorax (1), failed coronary sinus lead positioning (2), lead repositioning (2), atrial lead removal (1), left subclavian vein thrombosis (1), lead malfunction leading to VT under sensing and syncope (1). Device-administered therapies were eight; Inappropriate discharges (5), Appropriate discharges (1), successful Anti-tachycardia Pacing (2). Conclusions: We believe that ICDs are very effective life-saving devices but unfortunately they still are very expensive and their use can be associated with significant morbidities especially during the learning curve.