Nonthoracotomy versus thoracotomy cardioverter-defibrillator implantation: Long-term outcome

We compared the survival of 193 patients treated with implantable cardioverter-defibrillators according to the approach used in implantation: thoracotomy (87 patients) and nonthoracotomy (106 patients). Although the surgical (30-day) mortality rate was higher among thoracotomy patients, we found no difference in long-term survival between the groups. Short-term survival was better in nonthoracotomy patients, but the difference between the groups diminished quickly during the first few months and disappeared by six months. Thus, the results of trials that initially used thoracotomy cardioverter-defibrillators may be largely applicable to patients treated with nonthoracotomy devices.