201 Cardiac Device Related Complications Over 3 Years in a Large Volume Tertiary Centre

Abstract

Recent, controversial evidence suggests the complication rate in Australia and New Zealand for ICD/ Pacemaker procedures is ∼8.2%. It has been suggested that this figure is skewed by high complication rates in low volume centres. To investigate this, we analysed device related complications over 3 years in a large volume tertiary centre. A total of 1137 devices were implanted over 3 years with 815 new devices (72%), 288 generator changes (25%) and 34 device upgrades (3%). 204 (25%) of the new devices were implantable defibrillators. During the 3 year period, 83 (7.2%) of patients encountered a complication. 25 patients developed a pocket hematoma. Hematoma rates were 5% in patients anticoagulated and 1.25% without anticoagulation. 1 patient developed an infection requiring device extraction. 20 patients required lead revisions for lead dislodgement. 9 patients developed a pneumothorax requiring drainage. 1 patient required pericardiocentesis for RV perforation. There were an additional 10 pneumothoraces and 2 pericardial effusions which were not clinically significant. 15 patients developed other minor complications such as antibiotics allergies. There were no deaths. Even in a high volume centre, device implantation related complications occur at a rate of around 7%. This confirms previous work and should be used to ensure appropriate informed consent is gained from patients.