Springer Online Journal Archives 1860-2000
Abstract Recent technological advances in implantable defibrillator systems(ICD) have changed implantation approaches. The aim of this study was toinvestigate the influence of these improvements on procedure times,implant-related charges, patient recovery, and morbidity. Ninety-sixconsecutive patients undergoing implantation of a nonthoracotomy ICD werestudied. Implantation was performed under general anesthesia with thegenerator placed abdominally in 22 patients (group I) and pectorally in 40patients (group II). Thirty-four patients underwent pectoral implantationusing conscious sedation (group III). Groups were comparable with respect toclinical variables. Implantation duration and total procedure duration wereshorter in group III (67 ± 21 minutes and 117 ± 30 minutes)when compared with group I (100 ± 25 minutes and 157 ± 39minutes) and group II (86 ± 24 minutes and 153 ± 34 minutes, P〈 0.05). Patients in group III did not require admission to thePost-Anesthesia Care Unit. In contrast, patients in groups I and II spent 92± 28 minutes and 91 ± 31 minutes in the Post-Anesthesia CareUnit. Implantation-related charges were reduced in patients having pectoralimplantation using conscious sedation ($1451 ± 217 vs.$2354 ± 550 and $2796 ± 384, P 〈 0.05).Patients in group III had a lower frequency of postoperative oral analgesicuse (3.2 ± 2.7 doses, P 〈 0.05) and a shortened postoperative length of stay (1.9 ± 1.6 days, P 〈 0.05) when compared withgroups I (5.7 ± 4.0 doses and 3.3 ± 1.4 days) and II (5.2± 3.5 doses and 2.6 ± 1.1 days). The overall complication ratewas low (6.3%), with no differences between groups. Advances in ICDtechnology have simplified implantation, leading to shorter, less painful,and less expensive procedures.
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