Managing Long-Term Device-Related Complications in AICD Patients: A Prospective Study

Abstract

Objectives: To assess the long-term outcomes of patients with Automated Implantable Cardioverter Defibrillators (AICDs) at Hayatabad Medical Complex, Peshawar, with a focus on the prevalence and management of device-related complications over a one-year follow-up period. Methodology: This prospective cohort study included 250 patients aged 18 years and older with implanted AICDs, followed from August 2023 to July 2024. Data were collected through patient interviews, medical record reviews, and direct clinical assessments. The incidence of complications including inappropriate shocks, lead fractures, and infections was recorded. Kaplan-Meier survival analysis and other statistical tests were performed using SPSS version 25, with significance set at p < 0.05. Results: Device-related complications were observed in 30% of patients. Inappropriate shocks were the most common (18%), followed by lead fractures (8%) and infections (4%). These findings are consistent with international reports, which estimate complication rates between 25–35%, highlighting the need for context-specific management strategies. Kaplan-Meier analysis indicated an 80% survival probability at 12 months, reinforcing the importance of continuous monitoring and timely intervention to improve patient outcomes. Conclusion: The study emphasizes the necessity of enhanced follow-up protocols, patient education, and tailored management plans to minimize device-related complications in AICD patients. Implementing cost-effective, resource-sensitive strategies can significantly improve patient care, particularly in resource-limited healthcare settings like Pakistan.