Shoulder function after cardioverter defibrillator implantation: five year follow up

Abstract Background Implantable cardioverter defibrillator (ICD) represents the main tool for prevention of sudden cardiac death. Different kinds of post-implant complications were described; however, little is known about shoulder functional impairment and its impact on Quality-of-life (QoL). Methods Patients with standard indications for elective prepectoral subcutaneous ICD implantation were enrolled during a 1 year period. The impact of ICD implantation on shoulder motility, pain, general disability and QoL was evaluated prospectively at baseline, and after 2 weeks, 3 months, 1 and 5 years, using Constant Score, Numeric Rating Scale for pain and the Disability of the Arm, Shoulder and Hand score and the Short Form-36 questionnaire. Results A total of 50 patients were implanted with single, dual chamber or biventricular ICDs. 2 weeks after implantation functional impairment and mild pain were observed in ipsilateral shoulder movements, with a reduction in the SF-36 score. Shoulder functional impairment improved since third month evaluations, with almost normalization at 1 and 5 year assessments, as well as pain and QoL. Conclusions Prepectoral subcutaneous ICD implantation may be associated with ipsilateral shoulder functional impairment, that regresses partially after 3 months and completely at 1 and 5 year assessments. The less invasive implantation technique and the relatively small size of modern ICDs, independently from types and volumes, may be relevant to the degree of post-implantation shoulder functional impairment and recovery time. Shoulder function should be assessed at routine checks, especially soon after ICD implantation, because of potential functional impairment and subsequent impact on QoL.