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 hemothorax (1), failed coronary sinus lead positioning (2), lead re-positioning (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.