Key result
Endocardial ICD implantation is linked to shorter ICU and hospital stays versus epicardial placement.
Why the study?
Does endocardial ICD implantation improve procedural outcomes and reduce hospital stay compared to epicardial implantation in patients with severe ventricular tachyarrhythmias?
Observational (n=107)
Does endocardial ICD implantation improve procedural outcomes and reduce hospital stay compared to epicardial implantation in patients with severe ventricular tachyarrhythmias?
Endocardial ICD implantation reduces ICU and hospital stay and avoids thoracotomy compared to epicardial implantation, making it the preferred method for patients without concomitant surgery.
Endocardial ICD was associated with shorter ICU and hospital stays; leaves open superiority versus epicardial approaches in contemporary practice.
The implantable cardioverter-defibrillator (ICD) has proved to be an efficient device for the treatment of severe ventricular tachyarrhythmias (VT). From May 1985 to August 1991, the ICD was implanted in 107 patients of whom 72% suffered from coronary artery disease, 17% from cardiomyopathy, 5% from long QT-syndrome and 6% from other heart disease. All patients had a life threatening episode of VT or at least one episode of ventricular fibrillation. Of 107 implants, 12% were combined with other heart surgery, 55% were isolated epicardial implantations (epi I) and in 33%, the novel endocardial (endo I) approach was chosen. Between epi I and endo I we found no difference in operation time, but time for ICU and in-hospital stay was significantly shorter using the transvenous approach. In addition, sensing and pacing capability of the endocardial screw-in electrode was superior and the need for thoracotomy was avoided, a particular advantage in patients with previous heart surgery. Complications after epi I were: temporary low cardiac output, 1; perioperative death, 2; infection, 3, and after endo I: electrode dislocation, 2. Hence, endo I may become the method of choice for patients without concomitant surgery.
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Saggau et al. (1992) conducted an observational in Severe ventricular tachyarrhythmias or ventricular fibrillation (n=107). Endocardial ICD implantation vs. Epicardial ICD implantation was evaluated on Operation time, ICU stay, and in-hospital stay. Endocardial ICD implantation significantly shortened ICU and hospital stays compared to epicardial implantation, with complications including 2 electrode dislocations versus 2 perioperative deaths.
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