Complications with permanent endocardial electrode systems.

The different complications of endocardial electrode systems in 185 patients during the last seven years are discussed. The surgical technique for the now routinely used cephalic route is described. The choice of anaesthesia is discussed. In the last 39 implantations there have not been any displacements or retractions. Of the total number of patients only 3 required replacement of endocardial by myocardial electrodes. This was caused by unstable position and high stimulation threshold. Fracture of the electrode occurred in 4 cases. Stimulation of the diaphragm occurred in 10%, displacement and retraction of the electrodes in 6,5% and heart penetration or perforation in 3,8% of the patients. There was one death from cardiac tamponade due to electrode perforation of the right ventricle. One case had irreversible brain damage due to prolonged asystole during pulse generator replacement. Unimportant wound infections and haematomas occurred in 5 patients and phlebitis in 3 patients. More or less serious electrode complications have been seen in 56 of the 185 patients, 18 patients having more than one complication.