The course of 101 patients who received a pectoral ICD system was compared with the course of patients who had the system implanted abdominally. Early pocket revision may actually avoid infections. After recent reduction of case dimensions nearly all ICDs can be implanted subpectorally.
Exceptions are infants and extremely cachectic patients.
Only one incision is required for lead and generator placement. Possibly necessary subcutaneous or submuscular leads can be placed through the same incision. General anesthesia was used routinely. Exclusion criteria for the pectoral implantation technique was a poorly developed muscle layer or a cachectic patient. Patient's refusal or cosmetic aspects, especially in women were also contraindications.