Newer implantable defibrillators typically last seven or eight years, depending on how frequently they are called upon to perform their lifesaving task. One to three percent of patients die during or after thoracotomy, usually because of serious arrhythmias that resist correction or because of other heart or lung problems. Fortunately, the traditional open-chest implantation surgery is obsolete now, since almost all of the current defibrillator leads are implanted transvenously and connected to the pulse generator that is placed in the pectoral area. Implantation below the skin in the pectoral muscle without thoracotomy has meant a reduction in the number of patients who experience serious complications or die. One study reported that the risk for death around the time of implantation was less than 1 percent, a rate similar to that for pacemaker implantation.
Cost also falls because of shortened hospitalization.
Some researchers propose using it for appropriate patients as a front-line, or initial, therapy, which they believe would improve patient care and reduce costs overall. Implantation of a defibrillator may have a number of psychological side effects as well. Psychological counseling may help patients overcome the fear, anxiety, and depression that can complicate life with an implantable defibrillator. Although this form of treatment certainly is not without risks or potential complications, the people who require an implantable defibrillator already have high risk for sudden death. Studies suggest that without an implantable defibrillator 20 percent of these high-risk individuals would die within two years.