Implantable Cardiac Defibrillator (ICD) is a device that’s placed in the body to observe heart rhythms (Arrhythmias) and treat an irregular beat by sending electrical charges to the heart. It is a battery powered device and is used for those patients that run the risk of dangerous ventricular fibrillation. In simpler terms, this device is used for patients that are at a risk of unexpected cardiac death. Though, these ICDs are similar to pacemakers; still, they have differences. While pacemaker is a temporary device designed to treat bradycardia; ICD is a permanent solution against sudden abnormalities and tachycardia.
ICD is used for patients, either having low heart rhythm or too fast heart rate. It is a pager-sized titanium metal device that’s placed below the left collarbone. This small machine includes insulated wires passing through the vein to lower chambers of the heart. The wires carry electrical signals between heart and Defibrillator unit. The device’s usage is somewhat similar to those rubber pads used by surgeons to revive low heartbeat.
Usually, the ICDs are placed transvenously with devices positioned in the left pectoral region of the body. The implantation procedure is started by giving local anesthesia in the area, where ICD is to be placed. Insulated wire or wires are inserted in the veins of the upper chest near collarbone and placed on the inner wall of the heart. Other end of the wire is connected to the defibrillator unit, inserted under the skin at the incision site. After the procedure is complete, doctor will test ICD by giving shock to your heart. For this, you will be given general anesthesia to avoid any complication.
Implantable Cardiac Defibrillator delivers therapies according to the occurring heart problem. It is your doctor, who decides on the kinds of therapies required and the ICD is programmed for that. Following are the therapies performed by ICD:
- Defibrillation Therapy: it is one of the strongest forms of therapy that includes a shock, which may feel like a strong kick in the chest. It is used for patients with very low heart rates. The pain of this shock may last for only a few seconds and your heartbeat will return to normal rate.
- Cardio Version Therapy: This is a shock of a higher range, but less powerful than Defibrillation therapy. It is given to treat an abnormal fast heart rate and you may feel a thump in your chest.
- Low Energy Pacing Therapy: it is a very light electric shock given by ICD to treat minor disruptions in your heart. You might either feel no pain at all or a slight fluttering in the chest.
Since it is a permanent treatment of heart problems, it’s preferred over pacemakers. Modern designed ICDs have programmable features allowing doctor to change cut off heart rate to activate defibrillator. The aim of ICD is to prevent sudden death resulting from ventricular tachycardia and ventricular fibrillation.
Implantable Cardiac Defibrillator should not be used for the people, whose heart problems are temporary and who are allergic to exposed components in the body. Another thing to be kept in mind is that patient with ICD needs to avoid usage of certain home appliances that affect its task. Some of the tools that the patients should avoid are running car engines, theft detectors, metal detectors, MRI scan and all such devices having strong magnetic field. You should also avoid keeping digital mobile phones in the pocket near chest.
Pre and Post Care:
Before going for the surgery, you will be asked to stop taking blood thinning medicines. The patient would also be required to take antibiotics for avoiding infections after surgery. The pre care would also include you to undergo a chest x-ray, EPS (Electro physiology study) and an ECG (Electro cardiogram). You will also be asked to remove your hearing aids, dentures and contact lenses, before starting the surgical procedure. Lastly, you have to stop eating and drinking before one night before surgery.
After undergoing the surgery, you would be asked to avoid rigorous shoulder activities and lifting heavy weight. The surgeon will also stop you from doing strenuous exercises for approximately four weeks. He will also ask you to avoid driving for initial months after surgery.
Implantable Cardiac defibrillator accompanies certain risks, such as:
- Infection on the surgical area
- Rare complications, like Heart attack, blood clots and perforation of heart muscle or lung