Although the insertion of an AICD requires only minor surgery, it still carries some risks.
While complications are rare, patients should report any of the following symptoms immediately:
- Redness, warmth, tenderness or swelling of the incision site, alone or with a fever. Sometimes a hard ridge forms where the incision was closed. This will fade away as the wound heals.
- Drainage of liquid from the incision site, alone or with a fever.
- Increased shortness of breath, prolonged hiccuping or difficulty breathing.
- Fainting, lightheadedness or dizziness.
- Fast or pounding heartbeats (palpitations).
- Chest pain.
- Re-experiencing the same symptoms that they had before surgery.
Serious complications from the surgery occur in less than 1 percent of cases. These include:
- Severe bruising or bleeding
- Formation of a blood clot
- Torn blood vessel
- Punctured lung or heart muscle
- Stroke
- Heart attack
- Introduction of air into the space between the lung and chest wall
- Death
The risk of having one of these complications is increased if people have certain characteristics, such as the following:
- Advanced age
- Obesity (more than 20 pounds heavier than one’s ideal weight or body mass index 30 or greater)
- Severe lung disease (often due to smoking)
- Use of various medications
- Severely decreased heart function
Rarely, there may also be some complications with the AICD itself. As with any mechanical device, the AICD or the wires may malfunction. A small percentage of patients report at least one time in which the AICD delivered a shock when no arrhythmia was present. If patients feel a shock from the AICD, they should call their physician. If other symptoms occur such as dizziness, clamminess, palpitations, angina (chest pain), loss of consciousness or blackouts, patients are advised to call an ambulance and go to the emergency room, because their AICD may need reprogramming.
Some patients may sustain a cluster of episodes of ventricular tachycardia and/or ventricular fibrillation that results in multiple shocks (discharges) being administered by the AICD. This is known as an “electrical storm.” An electrical storm is when at least three shocks and/or anti-tachycardia pacing signals are delivered within 24 hours. Compared to AICD patients not having such an episode, AICD patients surviving an electrical storm have an increased risk of death, particularly within the first three months following the event. What precisely causes electrical storms is not known, but patients experiencing them tend to have ventricular tachycardia and an ejection fraction below 30 percent. They are also less likely to have undergone revascularization (e.g., coronary bypass). Patients who feel multiple discharges in a short time period should contact their physician, who will review the data recorded by the AICD and consider appropriate treatment.
