Why the study?
Does the use of dual-chamber ICDs compared to single-chamber ICDs increase the frequency of major complications in patients undergoing ICD implantation?
Does the use of dual-chamber ICDs compared to single-chamber ICDs increase the frequency of major complications in patients undergoing ICD implantation?
Dual-chamber ICDs are associated with a significantly higher incidence of major device- and lead-related complications compared to single-chamber ICDs.
Answers are grounded in this paper and cite their sources.
DC-ICDs were associated with more major complications; leaves open whether randomized trials should alter device selection.
Recently, the routine use of dual-chamber implantable cardioverter defibrillators (DC-ICD) has been advocated over the single-chamber version (SC-ICD), but there are few reports of the frequency of complications between the 2 types of ICDs. Between July 1997 and April 1999, 178 consecutive patients underwent implantation of either a transvenous SC-ICDs (n=104) or a DC-ICDs (n=74). Twelve (16%) of the 74 patients with a DC-ICD had a total of 16 major complications compared with 6 (6%) of the 104 patients with a SC-ICD (p=0.01). The 16 DC-ICD complications included atrial lead dislodgment (4), ventricular lead malfunction (4), and pocket infection/hematoma (3), and the 6 SC-ICD complications included ventricular lead dislodgment (2) and pocket hematoma (3). Patients with a DC-ICD had less left ventricular function (29% vs 35%, p=0.035) and a higher prevalence of non-ischemic cardiomyopathies (48% vs 28%, p=0.0076). In conclusion, the DC-ICD may have a higher frequency of device- and lead-related major complications.
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Takahashi et al. (2002) studied this question.
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