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During the last few decades, care for heart patients has significantly improved. The enormous increase in the number of diagnostic and therapeutic options has resulted in a much better prognosis for many patients with cardiovascular disorders. Implantable cardioverter defibrillators (ICDs) and resynchronization therapy combined with ICDs decrease the risk of sudden death due to ventricular arrhythmias and improve symptoms related to cardiovascular failure. Percutaneous valve implants and percutaneous techniques to repair valve leakages have improved the prognosis of patients deemed inoperable. As well as positive effects, all these interventions are associated with a risk of sometimes severe complications. Infections, perforations and even death can occur related to the procedure. Long term complications caused by infections in or failure of technically complicated devices and electrodes are still a threat for many patients. Careful multi-disciplinary patient selection prior to the procedure and extensive follow-up are therefore mandatory to achieve the best results for these procedures.