WHAT IS IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS (ICDS)?
ICD monitors the heart rate. It uses a battery for functioning. The doctor places this device in the chest of the patient. This device identifies the irregular heart rhythm and prevents or stops the arrhythmia. It generates the electrical impulses when it recognises the irregular heartbeat. Several studies conclude that ICD plays a vital role in preventing heart failure in patients who are at high risk for developing ventricular arrhythmia.
There are two types of ICDS. These are the traditional ICD and the subcutaneous ICD. The doctor may opt for subcutaneous ICD if the patients have structural defects in the heart.
WHEN DOES THE DOCTOR ADVISE THE PATIENTS TO USE ICDS?
The doctor may advise the implantation of ICD in the following conditions:
If the patient has a high risk of cardiac arrest
If there is a high risk of ventricular arrhythmia.
If the patient survived a sudden heart failure
If the patient has inherited disease, such as Brugada syndrome, that results in irregular heartbeats.
If the patient has long QT syndrome
If the patient has congenital heart disease, that increases the risk of sudden cardiac arrest
HOW THE PATIENT PREPARES FOR GETTING ICD?
ICD implantation is a surgical procedure. Further, it is into a patient who either had a cardiac arrest or is at risk of getting one. The patient undergoes several tests to determine his eligibility for the ICD implantation. These tests include:
Electrocardiography determines the speed of the heartbeat,
Echocardiography that shows any structural defect in the heart and the flow of blood
Holter monitoring tracks the heartbeat for 1-2 days before ICD implantation
Electrophysiology study helps the doctor determine the area that is causing the irregular heartbeat.
HOW DOES THE DOCTOR IMPLANT ICD?
The doctor inserts the IV line in the arm and administers sedatives, and may also give you general anaesthesia. First, the doctor inserts the wires through the vessels near the collarbone. The doctor then guides the wire with the help of an X-ray. He then attaches the wire either into or on the surface of the heart. Next, the doctor connects the other end of the wire with the pulse generator and implants it by making a pouch below the collar bone. The doctor then tests the ICD and programs it according to the need of the patient.
HOW ICD WORKS?
ICD senses any abnormal heartbeat. If the heartbeat is slow, it generates electrical impulses to normalise it. The ICD provides defibrillation shocks to prevent irregular heartbeat if it is too fast.
WHAT ARE THE RISKS WITH ICD IMPLANTATION?
The ICD implantation is relatively a safe procedure. However, there are certain complications with this procedure. These are damage to the blood vessels while guiding wire, swelling, bruising, bleeding, infection at the insertion site, movement of the leads that may damage the heart, heart valve dysfunction due to leads, and lung complications. Therefore, the patient must immediately consult the doctor if they have any discomfort in the heart or at the implantation site.
WHAT PRECAUTIONS ARE TO BE TAKEN POST- ICD IMPLANTATION?
The patients should take several precautions after ICD implantation. The patient should avoid the exposure of ICD to cellphones as it may interfere in its functioning. Similarly, care should be taken while passing through a security system and undergoing diagnostic imaging techniques. Do not ICD to magnets, wireless chargers, and headphones.