Comparison of implantation of nonthoracotomy defibrillators in the operating room versus the electrophysiology laboratory (original) (raw)

1995, The American Journal of Cardiology

Implantable cardioverter-defibrillators (ICOs) with nonthoracotomy lead systems are widely available, and are implanted either in the electrophysiology laboratory or the operating room. The purpose of this study was toprospectively evaluate the safely and efficacy of nonJhoracotomy ICD implantation in an eleclrophysiology laboratory versus an operating room. During a 7-month period, 62 consecutive ICDs with nonlhoracotomy lead Systems were implanted in patients in an electrophysiology laboratory. During the next 10 months, 110 consecutive ICDs were implanted in patients in a surgical operating room. All ICD implantations were performed under general anesthesia by eleclrophysiologists. There were no differences in age (58 + 14 vs 62:1:12 years, p = 0.06), gender dislribution (p = 0.3), frequency of slruclural heart disease (970 vs 97%, p = 0.9), ejection fraction (0.31 + 0.15 vs 0.29 :!: 0.13, p = 0.3), or presentation with ca~iac arrest (65% vs 53%, p = 0.2) between patients undergoing ICD implantation in the eleclrophys'mlogy laboratory and operating room, respediv~. The rate of successful implantation and of complications for systems implanted in the electmphysiology laboratory (95% and 13%, respectively) andin the operating room (98% and 14%, respectively) were similar (p = 0.4 and p = 0.8, respectively). Specifically, the rate of infection (0% vs 4%, p = 0.3) and hematoma formation (20 vs 4%, p = 0.8) were not statistically significanlly different. Three patients who had undergone ICD implantation in an operating room died within 30 days. ICDs with nonthoracotamy lead systems can be implanted with a similarly high rate of success and acceptable complication rate in the eleclmphysiology laboratory and in the operating room.