Automatic implantable cardioverter-defibrillator: appearance and complications

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Abstract
The automatic implantable cardioverter-defibrillator (AICD) can revert life-threatening arrhythmias to normal rhythms in ambulatory patients. The device continually monitors cardiac rhythm, and delivers cardioverting discharges when potentially life-threatening arrhythmias are recognized. The radiographs of 22 patients were reviewed with special reference to complications of radiologic interest, including pneumothorax, infiltrate, pleural effusion, atelectasis, and malposition of sensing or defibrillating leads. The normal radiographic appearance, surgical implantation, and clinical aspects of the AICD are discussed. A potential pitfall, an apparent connection gap at the epicardial electrode, was seen in three patients. This is due to limited radiodensity of part of the conduit. The AICD can lead to substantial improvement in survival rates of properly selected patients. Increasing use is probable, and radiologists should be aware of the normal appearance and complications of the AICD.

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