Echocardiographic Evaluation of Complications after Intracardiac Devices Implantation

Complications after device implantation are more frequent during the first month and more rare in long-term follow-up. Many factors are involved in the appearance of complications in patients with implanted devices. In short-term follow-up, the most frequent are pericardial effusions and infection. In long-term follow-up, the complications are linked to the lead's presence: pacemaker-induced cardiomyopathy in patients with right ventricle apical lead and tricuspid regurgitation in patients with implanted cardioverter because of a highdimension of the lead. It is essential to diagnose and adequately treat this pathology because of the negative prognosis. Transthoracic and transesophageal echocardiography are the main imaging techniques used in this approach. 1–2% of patients present complications in the first 30 days after pacemaker insertion and progressively decrease during long-term follow-up. Complication risks generally increase with the complexity of the device and comorbidities, are more common in device upgrading or lead revisions, and are lower inpatients with de novo implantation. The decision to upgrade to more complex systems or prophylactic replacement of CIED generators and leads must be carefully weighted. Complication rates are related toindividual and center implantation volumes.