• Rukmani Birla Hospital,Gopalpura Bypass Road, Near Triveni Bridge,Gopalpura,Jaipur – 302018.

AUTOMATED IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR

Human heart has an astounding ability to beat unfailingly for a lifetime which is a proof that it is one of the toughest muscles in our body which functions with an amazing working system. Almost like a machine! But all machines and systems face wear and tear and so does our heart. Sometimes, our heart gets into an uncanny rhythm. To make it bounce back to normalcy, tiny shock boxes come to rescue. These tiny shock boxes are now really compact to fit under the collarbone into a small pocket of muscle. Enter into the world of Implantable CardioverterDefibrillator!

What is an Automated Implantable CardioverterDefibrillator?

An implantable cardioverterdefibrillator (ICD) or automated implantable cardioverter defibrillator (AICD) is a small device which is kept in your chest to look into your heart rhythm and detect irregular heartbeats. It is usually supported by a lithium battery which has a life of 5‐ to 10‐years

What do ICDs do?

ICD tracks the rhythm of the heart. If it finds out any abnormal or irregular rhythm in the ventricles of the heart, it utilises very low-energy electrical pulses which are almost not noticed by the patient and restores the heart with a regular and normal rhythm.

What is an ICD made up of?

An ICD is made up of two main parts. The pulse generator which holds the battery, electronics and a capacitor, which saves the charge the device delivers to jolt the heart back into a normal rhythm. There are tiny lead wires that connect the device to the heart.

ICD is needed by:

When any one visits a doctor explaining any experiencing of feelings of heart beating quicker or slower than it should, it can be due to uncanny rhythms which can be fatal. These require instant help. ICDs come to rescue here.

Falling rates of sudden death

As the ICDs have become more and more common, the death rate of people suffering from heart disorders has started declining. In fact, sudden deaths due to heart failures has come down remarkably.

How does an ICD work?

The automated implantable cardioverter defibrillator is in charge of making the rhythms of the heart normal. Not only that, it recognises any irregularity in the rhythms and judges the right course of action that has to be taken to return the heartbeat to a normal heart back to normal.

The doctor programs the ICD to include one or all of the following functions:

  • Anti-tachycardia pacing (ATP) – small electrical impulses are sent to the heart muscle
  • Cardioversion –A gentle jolt is sent at the same time as the heartbeat
  • Defibrillation –During too rapid heartbeats, a higher-level jolt shock is sent to the heart muscle.
  • Bradycardia pacing –In too slow heart movements cases, small electrical impulses are sent

Types of ICDs

There are four types of ICDs:

  • Single chamber
  • Dual chamber
  • Biventricular
  • Subcutaneous

Is the ICD implant procedure safe?

A device implant is usually a very secure process. However, there could be a few minimalistic risks too. Special safety measures are usually taken to reduce these risks. A patient can discuss his specific concerns about the risks and benefits of the procedure with his doctor prior to deciding on this.

Where is the implant procedure performed?

In most of the cases, the implant takes place in a special room in the operation theatre specially meant for heart surgeries. When the epicardial implant is done, the procedure takes place in the surgeon’s cell.

How long can you live with a defibrillator?

Depending on usage and the type of device, ICDs generally last for 5 to 7 years or longer. In most cases, the patient leads a normal life with an ICD.

Risks

Usually ICD implantation do not have any major risks but a patient may encounter the following:

  • The part at which the implantation has been done, can get some infections
  • Some patients suffer from reactions like allergies towards the medication used
  • The part at which the implantation has been done, may get swollen, start bleeding or may get bruised
  • The vein where the ICD leads are placed gets damaged
  • Another fatal condition arises when the area around the heart of the patient starts bleeding.
  • The heart valve where the ICD lead is placed starts leaking blood.
  • The lung collapses. (pneumothorax)

Conclusion:

ICDs have become an ideal remedy for anyone who has managed to come out of heart attack and they are progressively used in people at a soaring jeopardy of sudden cardiac arrest. An ICD lowers the risk of unforeseen death from cardiac arrest more than medication alone. Although the electrical shocks can be full of dismay, they are an indication that the ICD is effectively dealing with the heart rhythm problem and protecting from sudden death. ICDs are by far one of the best inventions of medical science.

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