ICD Implantation


DESCRIPTION

Implantable Cardioverter Defibrillator (ICD) is a small battery powered electrical impulse generator implanted in the chest or abdomen of patients who are at high risk of conditions like sudden cardiac arrest due to abnormally fast heart rhythms called ventricular tachycardia which can lead to death. Another cause for cardiac arrest may be ventricular fibrillation. It is an irregular heartbeat rhythm which results in the quivering of heart muscles and cease pumping blood to the rest of the body. This device is programmed to detect cardiac arrhythmia or abnormal heartbeat rhythms and correct them by delivering jolts of electricity. If the heartbeat is normal, then the device remains inactive. The heart has its own internal electrical system that controls the rate and rhythm of the heartbeat. With each heartbeat, an electrical signal spreads from the top of the heart to the bottom which coordinates the timing of the heart cell activity. When life threatening situations like ventricular arrhythmias occur, the heart can’t effectively pump blood and immediate death may occur. To prevent this, the condition must be treated right away with an electric shock to the heart. This treatment is called defibrillation. An ICD has wires with electrodes on the end that connect to the heart chambers. The ICD will continually monitor the heart rhythm and whenever it detects an irregular rhythm in the ventricles, it will use low energy electrical pulses to restore a normal rhythm. If the low energy pulses don’t restore the normal heartbeat rhythm, then it will switch to high energy electrical pulses for defibrillation. These pulses last only a fraction of a second, but they can be painful.


THE PROCESS

The process of ICD implantation is similar to that of pacemaker implantation. The difference between a pacemaker and an ICD is that a pacemaker gives out only low energy electric pulses and they are used to treat less dangerous heart rhythms whereas ICD can be used to treat any condition of irregular or abnormal heartbeat rhythms. Most modern ICD’s can act as both pacemakers and defibrillators.  During an ICD implantation, the patient is temporarily sedated. An ICD is usually placed in the right or left upper chest near the collarbone. The lead is inserted into a vein located in the upper chest and the tip of the lead is placed on the inner wall of the heart with the help of x-rays. If there is more than one lead, the process is repeated. The other end of the lead is connected to the defibrillator unit which is then inserted into the incision site. Heavy sedation is used to test the ICD. It involves inducing a rapid heart rhythm and allowing the defibrillator to detect the abnormal rhythm and then terminate it with a shock or electrical pulse.


DURATION OF THE PROCESS

The procedure may take up to 2-3 hrs.


HOSPITALIZATION PERIOD
After an ICD implantation, the patient will be hospitalized for 1-2 days.


TIME SPAN OF RECOVERY

International patients or medical tourists can return to their home country within 1-2 weeks from the ICD implant.



AFTERCARE GUIDELINES
After an ICD implant, the patient must follow certain guidelines for speedy and healthy recovery.
  • After the procedure, the patient is advised not to drive for at least a week.
  • For a few days after the surgery, the patient may experience mild pain which can be relieved with medicines but he/she should consult the doctor before taking any such medicine.
  • If, at any time the patient feels strong shocks or electrical pulses from his ICD, the he should immediately consult the doctor.
  • The patient should avoid close or prolonged contact with electrical devices or devices that have strong magnetic fields like cell phones, MP3 players, microwave ovens, high tension wires, metal detectors industrial welders, electrical generators etc. as they may disrupt the electrical signaling of the ICD and prevent it from working properly.
  • He/she should also avoid medical procedures like MRI scans, shock-wave lithotripsy etc.
  • ICD batteries last between 5 and 7 years. Your doctor will replace the generator along with the battery before the battery begins to run down.


THE RISKS

Although rare, there can be some complications which are related to the surgery used to place the device. These include:

  • Swelling, bruising, or infection at the area where the ICD was placed.
  • Bleeding from the site where the ICD was placed.
  • Blood vessel, heart, or nerve damage
  • Collapsed lung
  • Reaction to the medicine used in sedation during the surgery.


RESULT

Patients who have successfully implanted ICD’s are found to be living healthier and happier than before. Even though it does place some restriction on the patient’s lifestyle, ICD’s have turned out to demonstrate life-saving benefits to patients over the years.


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