The value and limitations of a wound inspection clinic after cardiac device implantation

Background: Due to the growing number of cardiac device implantations it is important to develop methods to reduce device-implantation related complications.

Aims: To determine whether a wound inspection clinic can play a role in the detection of device-implantation related complications.

Methods: Single-center observational study evaluating patients who received a pacemaker or implantable cardioverter-defibrillator (ICD).

Results: Of 159 patients who received an appointment for the wound inspection clinic, 52 (33%) received a pacemaker and 107 (67%) received an ICD. The majority had no signs of infection. Pain (n=13, 8%) and swelling (n=11, 7%) were the most frequent signs observed, but they never necessitated intervention and recovered spontaneously in all patients. During follow-up (mean 20 9 weeks), complications occurred in 10 patients (6%). Most complications occurred early, within 4 days after implantation. The two late complications (at 19 and 41 days) could not be recognized at the wound inspection clinic.

Conclusion: We found no useful role for a wound inspection clinic two weeks post-implant to detect device-related complications. Open rapid access to the pacemaker/ICD center for patients with signs and symptoms of (threatening) complications seems to be more appropriate to manage post-implant patients. Crown Copyright (C) 2009 Published by Elsevier B.V. on behalf of European Society of Cardiology. All rights reserved.