We use cookies to improve your experience. By continuing to browse this site, you accept our cookie policy.×
Skip main navigation
Aging Health
Bioelectronics in Medicine
Biomarkers in Medicine
Breast Cancer Management
CNS Oncology
Colorectal Cancer
Concussion
Epigenomics
Future Cardiology
Future Medicine AI
Future Microbiology
Future Neurology
Future Oncology
Future Rare Diseases
Future Virology
Hepatic Oncology
HIV Therapy
Immunotherapy
International Journal of Endocrine Oncology
International Journal of Hematologic Oncology
Journal of 3D Printing in Medicine
Lung Cancer Management
Melanoma Management
Nanomedicine
Neurodegenerative Disease Management
Pain Management
Pediatric Health
Personalized Medicine
Pharmacogenomics
Regenerative Medicine

Implantable cardioverter defibrillator management: an update

    Michele Malagù

    Department of Cardiology, University of Ferrara, S Anna Hospital, Ferrara, Italy

    ,
    Alessandra Ferri

    Department of Cardiology, University of Ferrara, S Anna Hospital, Ferrara, Italy

    ,
    Ottavia Mancuso

    Department of Cardiology, University of Ferrara, S Anna Hospital, Ferrara, Italy

    ,
    Filippo Trevisan

    Department of Cardiology, University of Ferrara, S Anna Hospital, Ferrara, Italy

    ,
    Marianna Nardozza

    Department of Cardiology, University of Ferrara, S Anna Hospital, Ferrara, Italy

    &
    Matteo Bertini

    *Author for correspondence:

    E-mail Address: doc.matber@gmail.com

    Department of Cardiology, University of Ferrara, S Anna Hospital, Ferrara, Italy

    Published Online:https://doi.org/10.2217/fca-2016-0031

    Implantable cardioverter defibrillator (ICD) is the cornerstone of primary and secondary prevention of sudden cardiac death. In 35 years of technologic improvement and clinical trials, there has been a continuous increase in implantation rate. Purpose of this review is to point out and discuss every aspect related to actual ICD management, investigating implantation procedure and predischarge care, office and remote monitoring follow-up, diagnostic evaluations, management of patients with suspected therapies or malfunctions, heart failure, surgery, radiotherapy and endoscopic procedures. Also, ICD backface such as infections and other complications will be discussed. Finally, we will focus on interesting future perspectives for this setting of patients.

    Papers of special note have been highlighted as: •• of considerable interest

    References

    • 1 Mendis SPP, Norrving B. Global atlas on cardiovascular disease prevention and control. WHO, Geneva, Switzerland (2011). www.world-heart-federation.org.
    • 2 Priori SG, Blomström-Lundqvist C, Mazzanti A et al. Authors/Task Force Members; Document Reviewers. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC) Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur. Heart J. 36(41), 2793–2867 (2015). •• These are the European Guidelines and landmark on the subject.
    • 3 Mozaffarian D, Benjamin EJ, Go AS et al. Heart disease and stroke statistics-2016 update: a report from the American Heart Association. Circulation 133(4), e38–e360 (2016).
    • 4 Cobb LA, Baum RS, Alvarez H III, Schaffer WA. Resuscitation from out-of-hospital ventricular fibrillation: 4 years follow-up. Circulation 52(Suppl. 6), III223–III235 (1975).
    • 5 Berdowski J, ten Haaf M, Tijssen JG, Chapman FW, Koster RW. Time in recurrent ventricular fibrillation and survival after out-of-hospital cardiac arrest. Circulation 122(11), 1101–1108 (2010).
    • 6 Mirowski M, Reid PR, Mower MM et al. Termination of malignant ventricular arrhythmias with an implanted automatic defibrillator in human beings. N. Engl. J. Med. 303(6), 322–324 (1980).
    • 7 Trappe HJ. The “modern” implantable cardioverter-defibrillator: comparing it to those of the late 1980s. Am. J. Cardiol. 78(5A), 3–8 (1996).
    • 8 Hohnloser SH, Kuck KH, Dorian P et al. Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. N. Engl. J. Med. 351(24), 2481–2488 (2004).
    • 9 Steinbeck G, Andresen D, Seidl K et al. Defibrillator implantation early after myocardial infarction. N. Engl. J. Med. 361(15), 1427–1436 (2009).
    • 10 Elliott PM, Anastasakis A, Borger MA et al. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur. Heart J. 35(39), 2733–2779 (2014).
    • 11 Holley LK. Development of device therapy for ventricular arrhythmias. Heart Lung Circ. 16(3), 162–169 (2007).
    • 12 Sweeney MO. Antitachycardia pacing for ventricular tachycardia using implantable cardioverter defibrillators. Pacing Clin. Electrophysiol. 27(9), 1292–1305 (2004).
    • 13 Wietholt D, Block M, Isbruch F et al. Clinical experience with antitachycardia pacing and improved detection algorithms in a new implantable cardioverter-defibrillator. J. Am. Coll. Cardiol. 21(4), 885–894 (1993).
    • 14 Swerdlow CD, Friedman PA. Advanced ICD troubleshooting: part I. Pacing Clin. Electrophysiol. 28(12), 1322–1346 (2005).
    • 15 Poole JE, Johnson GW, Hellkamp AS et al. Prognostic importance of defibrillator shocks in patients with heart failure. N. Engl. J. Med. 359(10), 1009–1017 (2008).
    • 16 Ellenbogen KA, Kay GN, Lau C, Wilkoff BL. Clinical Cardiac Pacing, Defibrillation And Resynchronization Therapy (3rd Edition). Saunders, Elsevier Inc., Philadelphia, PA, USA (2007).
    • 17 Migliore F, Curnis A, Bertaglia E. Axillary vein technique for pacemaker and implantable defibrillator leads implantation: a safe and alternative approach? J. Cardiovasc. Med. (Hagerstown) 17(4), 309–313 (2016).
    • 18 Kirkfeldt RE, Johansen JB, Nohr EA, Moller M, Arnsbo P, Nielsen JC. Pneumothorax in cardiac pacing: a population-based cohort study of 28,860 Danish patients. Europace 14(8), 1132–1138 (2012).
    • 19 Blatt JA, Poole JE, Johnson GW et al. No benefit from defibrillation threshold testing in the SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial). J. Am. Coll. Cardiol. 52(7), 551–556 (2008).
    • 20 Brignole M, Occhetta E, Bongiorni MG et al. Clinical evaluation of defibrillation testing in an unselected population of 2,120 consecutive patients undergoing first implantable cardioverter-defibrillator implant. J. Am. Coll. Cardiol. 60(11), 981–987 (2012).
    • 21 Stavrakis S, Patel NH, Reynolds DW. Defibrillation threshold testing does not predict clinical outcomes during long-term follow-up: a meta-analysis. Pacing Clin. Electrophysiol. 36(11), 1402–1408 (2013).
    • 22 Birnie D, Tung S, Simpson C et al. Complications associated with defibrillation threshold testing: the Canadian experience. Heart Rhythm 5(3), 387–390 (2008).
    • 23 van Rees JB, Borleffs CJ, de Bie MK et al. Inappropriate implantable cardioverter-defibrillator shocks: incidence, predictors, and impact on mortality. J. Am. Coll. Cardiol. 57(5), 556–562 (2011).
    • 24 Moss AJ, Schuger C, Beck CA et al. Reduction in inappropriate therapy and mortality through ICD programming. N. Engl. J. Med. 367(24), 2275–2283 (2012).
    • 25 Tan VH, Wilton SB, Kuriachan V, Sumner GL, Exner DV. Impact of programming strategies aimed at reducing nonessential implantable cardioverter defibrillator therapies on mortality: a systematic review and meta-analysis. Circ. Arrhythm. Electrophysiol. 7(1), 164–170 (2014).
    • 26 Schaer B, Kühne M, Reichlin T, Osswald S, Sticherling C. Incidence of and predictors for appropriate implantable cardioverter-defibrillator therapy in patients with a secondary preventive implantable cardioverter-defibrillator indication. Europace 18(2), 227–231 (2016).
    • 27 Reynolds MR, Cohen DJ, Kugelmass AD et al. The frequency and incremental cost of major complications among medicare beneficiaries receiving implantable cardioverter-defibrillators. J. Am. Coll. Cardiol. 47(12), 2493–2497 (2006).
    • 28 Ezzat VA, Lee V, Ahsan S et al. A systematic review of ICD complications in randomised controlled trials versus registries: is our ‘real-world’ data an underestimation? Open Heart 2(1), e000198 (2015).
    • 29 Kirkfeldt RE, Johansen JB, Nohr EA, Jørgensen OD, Nielsen JC. Complications after cardiac implantable electronic device implantations: an analysis of a complete, nationwide cohort in Denmark. Eur. Heart J. 35(18), 1186–1194 (2014).
    • 30 Lee DS, Krahn AD, Healey JS et al. Evaluation of early complications related to De novo cardioverter defibrillator implantation insights from the Ontario ICD database. J. Am. Coll. Cardiol. 55(8), 774–782 (2010).
    • 31 Pang BJ, Barold SS, Mond HG. Injury to the coronary arteries and related structures by implantation of cardiac implantable electronic devices. Europace 17(4), 524–529 (2015).
    • 32 Kutinsky IB, Jarandilla R, Jewett M, Haines DE. Risk of hematoma complications after device implant in the clopidogrel era. Circ. Arrhythm. Electrophysiol. 3(4), 312–318 (2010).
    • 33 van Rees JB, de Bie MK, Thijssen J, Borleffs CJ, Schalij MJ, van Erven L. Implantation-related complications of implantable cardioverter-defibrillators and cardiac resynchronization therapy devices: a systematic review of randomized clinical trials. J. Am. Coll. Cardiol. 58(10), 995–1000 (2011).
    • 34 Buiten MS, De Bie MK, Van Der Heijden AC et al. Chronic kidney disease and implantable cardioverter defibrillator related complications: 16 years of experience. J. Cardiovasc. Electrophysiol. 25(9), 998–1004 (2014).
    • 35 Birnie DH, Healey JS, Wells GA et al. Pacemaker or defibrillator surgery without interruption of anticoagulation. N. Engl. J. Med. 368(22), 2084–2093 (2013).
    • 36 Doughty DB. Preventing and managing surgical wound dehiscence. Adv. Skin Wound Care 18(6), 319–322 (2005).
    • 37 Korantzopoulos P, Sideris S, Dilaveris P, Gatzoulis K, Goudevenos JA. Infection control in implantation of cardiac implantable electronic devices: current evidence, controversial points, and unresolved issues. Europace 18(4), 473–478 (2015).
    • 38 Da Costa A, Kirkorian G, Cucherat M et al. Antibiotic prophylaxis for permanent pacemaker implantation: a meta-analysis. Circulation 97(18), 1796–1801 (1998).
    • 39 Bloom HL, Constantin L, Dan D et al. Implantation success and infection in cardiovascular implantable electronic device procedures utilizing an antibacterial envelope. Pacing Clin. Electrophysiol. 34(2), 133–142 (2011).
    • 40 Polyzos KA, Konstantelias AA, Falagas ME. Risk factors for cardiac implantable electronic device infection: a systematic review and meta-analysis. Europace 17(5), 767–777 (2015).
    • 41 Magyar-Russell G, Thombs BD, Cai JX et al. The prevalence of anxiety and depression in adults with implantable cardioverter defibrillators: a systematic review. J. Psychosom. Res. 71(4), 223–231 (2011).
    • 42 Braunschweig F, Boriani G, Bauer A et al. Management of patients receiving implantable cardiac defibrillator shocks: recommendations for acute and long-term patient management. Europace 12(12), 1673–1690 (2010).
    • 43 Starrenburg A, Pedersen S, van den Broek K, Kraaier K, Scholten M, Van der Palen J. Gender differences in psychological distress and quality of life in patients with an ICD 1 year postimplant. Pacing Clin. Electrophysiol. 37(7), 843–852 (2014).
    • 44 van der Heijden AC, Borleffs CJ, Buiten MS et al. Clinical course of patients with implantable cardioverter-defibrillators: extended experience on clinical outcome, device replacements, and device-related complications. Heart Rhythm 12(6), 1169–1176 (2015).
    • 45 Sabbag A, Suleiman M, Laish-Farkash A et al. Contemporary rates of appropriate shock therapy in patients who receive implantable device therapy in a real-world setting: from the Israeli ICD registry. Heart Rhythm 12(12), 2426–2433 (2015).
    • 46 Singh SN, Poole J, Anderson J et al. Role of amiodarone or implantable cardioverter/defibrillator in patients with atrial fibrillation and heart failure. Am. Heart J. 152(5), 974.e7–974.e11 (2006).
    • 47 Sears SF, Todaro JF, Urizar G et al. Assessing the psychosocial impact of the ICD: a national survey of implantable cardioverter defibrillator health care provides. Pacing Clin. Electrophysiol. 23(6), 939–945 (2000).
    • 48 Rosenqvist M, Beyer T, Block M, den Dulk K, Minten J, Lindemans F. Adverse events in transvenous implantable cardioverter-defibrillators: a prospective multicenter study. European 7219 Jewel ICD investigators. Circulation 98(7), 663–670 (1998).
    • 49 Daubert JP, Zareba W, Cannom DS et al. Inappropriate implantable cardioverter-defibrillator shocks in MADIT II: frequency, mechanisms, predictors, and survival impact. J. Am. Coll. Cardiol. 51(14), 1357–1365 (2008).
    • 50 Shah H, Mezu U, Patel D et al. Mechanisms of inappropriate defibrillator therapy in a modern cohort of remotely monitored patients. Pacing Clin. Electrophysiol. 36(5), 547–552 (2013).
    • 51 Hohnloser SH, Al-Khalidi HR, Pratt CM et al. Electrical storm in patients with an implantable defibrillator: incidence, features, and preventive therapy: insights from a randomized trial. Eur. Heart J. 27(24), 3027–3032 (2006).
    • 52 Sesselberg HW, Moss AJ, McNitt S et al. Ventricular arrhythmia storms in postinfarction patients with implantable defibrillators for primary prevention indications: a MADIT-II substudy. Heart Rhythm 4(11), 1395–1402 (2007).
    • 53 Epstein AE, Dimarco JP, Ellenbogen KA et al. ACC/AHA/HRS 2008 Guidelines for devices-based therapy of cardiac rhythm abnormalites. Heart Rhythm 5(6), e1–e62 (2008).
    • 54 Cronin EM, Varma N. Remote monitoring of cardiovascular implanted electronic devices: a paradigm shift for the 21th century. Expert Rev. Med. Devices 9(4), 367–376 (2012).
    • 55 Sørensen JT, Clommensen P, Sejersten M. Telecardiology: past, present and future. Rev. Esp. Cardiol. 66(3), 212–218 (2013).
    • 56 Varma N, Epstein AE, Irimpen A, Schweikert R, Love C. TRUST Investigators. Efficacy and safety of automatic remote monitoring for implantable cardioverter-defibrillator follow-up: the Lumos-T Safely Reduces Routine Office Device Follow-up (TRUST) trial. Circulation 122(4), 325–332 (2010).
    • 57 Varma N, Michalski J, Epstein AE, Schweikert R. Automatic remote monitoring of implantable cardioverter-defibrillator lead and generator performance: the Lumos-T Safely RedUceS RouTine Office Device Follow-Up (TRUST) trial. Circ. Arrhythm. Electrophysiol. 3(5), 428–436 (2010).
    • 58 Martin DT, Bersohn MM, Waldo AL et al. Randomized trial of atrial arrhythmia monitoring to guide anticoagulation in patients with implanted defibrillator and cardiac resynchronization devices. Eur. Heart J. 36(26), 1660–1668 (2015).
    • 59 Vollmann D, Nägele H, Schauerte P et al. Clinical utility of intrathoracic impedance monitoring to alert patients with an implanted device of deteriorating chronic heart failure. Eur. Heart J. 28(15), 1835–1840 (2007).
    • 60 Boriani G, Da Costa A, Ricci RP et al. The MOnitoring Resynchronization dEvices and CARdiac patiEnts (MORE-CARE) randomized controlled trial: Phase 1 results on dynamics of early intervention with remote monitoring. J. Med. Internet. Res. 15(8), e167 (2013).
    • 61 Oliveira M, Cunha PS, Da Silva N. Remote monitoring for follow-up of patients with implantable cardiac device. Rev. Port. Cardiol. 32(3), 185–190 (2013).
    • 62 Parekh PJ, Buerlein RC, Shams R, Herre J, Johnson DA. An update on the management of implanted cardiac devices during electrosurgical procedures. Gastrointest. Endosc. 78(6), 836–841 (2013).
    • 63 Crossley GH, Poole JE, Rozner MA et al. The Heart Rhythm Society (HRS)/American Society of Anesthesiologists (ASA) Expert Consensus Statement on the perioperative management of patients with implantable defibrillators, pacemakers and arrhythmia monitors: facilities and patient management this document was developed as a joint project with the American Society of Anesthesiologists (ASA), and in collaboration with the American Heart Association (AHA), and the Society of Thoracic Surgeons (STS). Heart Rhythm 8(7), 1114–1154 (2011).
    • 64 Nordbeck P, Ertl G, Ritter O. Magnetic resonance imaging safety in pacemaker and implantable cardioverter defibrillator patients: how far have we come? Eur. Heart J. 36(24), 1505–1511 (2015).
    • 65 Petersen BT, Hussain N, Marine JE et al. Technology Assessment Committee. Endoscopy in patients with implanted electronic devices. Gastrointest. Endosc. 65(4), 561–568 (2007).
    • 66 St. Jude Medical. Effect of endoscopy on St. Jude medical implantable cardiac rhythm devices. www.sjm.com/∼/media/pro.
    • 67 Cuschieri JR, Osman MN, Wong RC, Chak A, Isenberg GA. Small bowel capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators: outcome analysis using telemetry review. World J. Gastrointest. Endosc. 4(3), 87–93 (2012).
    • 68 Stanich PP, Kleinman B, Betkerur K, Mehta Oza N, Porter K, Meyer MM. Video capsule endoscopy is successful and effective in outpatients with implantable cardiac devices. Dig. Endosc. 26(6), 726–730 (2014).
    • 69 Leighton JA, Sharma VK, Srivathsan K et al. Safety of capsule endoscopy in patients with pacemakers. Gastrointest. Endosc. 59(4), 567–569 (2004).
    • 70 Harris LA, Hansel SL, Rajan E et al. Capsule endoscopy in patients with implantable electromedical devices is safe. Gastroenterol. Res. Pract. 2013, 959234 (2013).
    • 71 Bandorski D, Höltgen R, Stunder D, Keuchel M. Capsule endoscopy in patients with cardiac pacemakers, implantable cardioverter defibrillators and left heart assist devices. Ann. Gastroenterol. 27(1), 3–8 (2014).
    • 72 Magnani A, Balbo P, Facchini E, Occhetta E, Marino P. Lack of interference of electromagnetic navigation bronchoscopy to implanted cardioverter-defibrillator: in-vivo study. Europace 16(12), 1767–1771 (2014).
    • 73 Zecchin M, Morea G, Severgnini M et al. Malfunction of cardiac devices after radiotherapy without direct exposure to ionizing radiation: mechanisms and experimental data. Europace 18(2), 288–293 (2016).
    • 74 Hurkmans CW, Knegjens JL, Oei BS et al. Management of radiation oncology patients with a pacemaker or ICD: a new comprehensive practical guideline in The Netherlands. Dutch Society of Radiotherapy and Oncology (NVRO). Radiat. Oncol. 7, 198 (2012).
    • 75 Borleffs CJ, van Erven L, van Bommel RJ et al. Risk of failure of transvenous implantable cardioverter-defibrillator leads. Circ. Arrhythm. Electrophysiol. 2(4), 411–416 (2009).
    • 76 Lambiase PD, Barr C, Theuns DA et al. Worldwide experience with a totally subcutaneous implantable defibrillator: early results from the EFFORTLESSS-ICD Registry. Eur. Heart J. 35(25), 1657–1665 (2014).
    • 77 Reddy VY, Exner DV, Cantillon DJ et al. Percutaneous implantation of an entirely intracardiac leadless pacemaker. N. Engl. J. Med. 373(12), 1125–1135 (2015).
    • 78 Reynolds D, Duray GZ, Omar R et al. A leadless intracardiac transcatheter pacing system. N. Engl. J. Med. 374(6), 533–541 (2016).