Complications
May require urgent device replacement or modification of one or more components of the implantable cardioverter defibrillator (ICD) system. However, if the failure rate is sufficiently low and is less than the risk of ICD replacement, optimal management of devices that are prone to failure may consist of close observation of the patient rather than prophylactic device replacement.
Patients who develop sustained ventricular tachycardia in the context of left ventricular systolic dysfunction often have re-entrant rhythms around myocardial scars. Such re-entrant circuits can degenerate to ventricular fibrillation and are associated with a high mortality rate.
ventricular tachycardia is a common cause of sudden cardiac death.
Often results from bacteraemia. Infection may occur along the intravascular portion of the leads or in the generator pocket. Risk factors for infection include comorbid conditions such as diabetes and chronic obstructive pulmonary disease, as well as oral anticoagulation therapy and corticosteroid use. Measures such as antibiotic prophylaxis and good patient education on wound care can help reduce risk.[46] Treatment usually requires complete removal of the implantable cardioverter defibrillator system and a prolonged course of antibiotics.
Frequent or incessant idiopathic ventricular premature complexes or non-sustained ventricular tachycardia have been associated with a reversible, tachycardia-induced cardiomyopathy that regresses following therapy with medications or catheter ablation.[58]
Amiodarone can cause adverse effects, including thyroid dysfunction (both hypo- and hyperthyroidism).
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