Complications of Implantable Defibrillators

An implantable defibrillator is a life-saving device that is surgically implanted in order to monitor the patient’s heart rhythms and can automatically deliver a does of electrical shock to defibrillate the heart in the event that it suffers arrhythmias.  It works the same way as Philips defibrillators but is activated inside the body. While implantable cardioverter defibrillators (ICDs) are quite effective at preventing cardiac demise there are some complications both surgical and post-surgical that require discussion.

Surgical Complications of ICDs

The main problems caused by inserting an implantable defibrillator are bleeding, pneumothorax, infection and injury to the heart and its surrounding blood vessels.  The risk of having any of the above complications is around 2-3 percent and the risk of dying as a result of the procedure is about the same.

Infection                                     

The only exception to the above is infection.  If an ICD device becomes infected with bacteria, the entire system including the generator and the leads need to be removed in order to control the infection with antibiotics. Once the infection is controlled, the patient needs to undergo implantation with a new ICD device.

The main problem with ICDs is that they require constant replacement particularly the generators, which require changing once every six or seven years when it wears out. While the risk of complications is lower, there is still some risk of infection that is higher compared to the initial surgery.

Post-Surgical Problems

Unlike automatic external defibrillators that carry lesser risk because they are applied only externally to the skin, ICDs can have post-surgical complications here are some of the most common.

Lead complications – this occurs when there is dislodgement when the leads “move” from their correct positions. There is also a risk of lead fracture, which can result in a loss of effectiveness of the entire system. Abnormal shocks can also occur as a result.

Pain, skin erosion and bleeding – this happens when the ICD generator is displaced.

Inappropriate Shocks – may occur causing pain and at times psychological trauma to the patient as he feels he is being punished or feels anxious all the time due to an imminent shock beyond his control.