Guard Against Arrhythmias With Implantable Cardioverter Defibrillator

What is an implantable cardioverter-defibrillator?

An Implantable Cardioverter Defibrillator (ICD) is a battery-powered pulse generator that is implanted underneath skin and connected to heart below collarbone to keep track of your heart rate.  An ICD is made up of two main components, i.e. Battery-powered pulse generator with tiny computer and antenna and a capacitor to store the electrical charge that the device delivers to shock the heart back into a normal rhythm. The wires or leads from electric pulse generator and capacitor connect ICD device to the heart.

The human heart has a fantastic electrical system in the heart that sends impulses to maintain regular heart rhythm. In many cases, heart veers into an abnormal rhythm, i.e. arrhythmias and may cause potentially deadly conditions such as ventricular tachycardia and ventricular fibrillation.

Implantable cardioverter defibrillators (ICDs) are used to detect dangerously fast heartbeats, i.e., ventricular tachycardia and ventricular fibrillation, and generate lifesaving and defibrillating shock or impulses to correct the cardiac rhythm. ICDs are objectively implanted to prevent sudden death or cardiac arrest.

Newer-generation ICDs has also equipped with pacemaker features that stimulate the heart to beat if the heart rate is detected to be too slow. For patients at high risk for the deadliest forms of arrhythmias – called ventricular tachycardia and ventricu­lar fibrillation – an internal “shocking” device may be the best protection against sudden cardiac arrest (SCA).

Why might I need an implantable cardioverter-defibrillator?

You might be recommended implantable cardioverter defibrillation if you are at risk of life-threatening and deadliest forms of ventricular arrhythmias called ventricular tachycardia and ventricu­lar fibrillation.

Doctors suggest ICDs if you have:

• Had a ventricular arrhythmia
• Had a heart attack
• Survived a sudden cardiac arrest
• An inherited heart defect like Long QT syndrome
• Brugada syndrome

Also, for Congenital Heart Disease or other underlying conditions that can cause sudden cardiac arrest, an internal “shocking” device, I.e. ICD may provide the best protection against sudden cardiac arrest (SCA).

What are the risks of an implantable cardioverter-defibrillator?

Although ICD implantation is quite safe yet you may have:

• Infection at the implant site
• Inflammation, bruising or bleeding  at the site of  ICD implant
• Allergic reaction to Anesthesia or medications used during the procedure
• Damage to the vein where ICD leads are placed
• Life-threatening Bleeding around your heart
• Blood leakage through the heart valve where the ICD lead has placed
• Collapsed lung (Pneumothorax)

How do I get ready for an implantable cardioverter-defibrillator?

To confirm whether you require ICD or not, you will have asked for some tests like:

• Electrocardiography (ECG)
• Echocardiography
• Holter monitoring
• Event recorder
• Electrophysiology study (EPS).

Before the implantation of ICD, to facilitate administration of anesthesia, you asked to keep your stomach empty.

The area beneath collar bone will be shaved and cleaned with disinfectant for placement of ICD.

What is the cost of ICD implantation in India?

Cost of ICD implantation in India depends upon various factors such as:

• Doctor’s status and expertise
• Type of Hospital
• Kind of ICD implant
• Procedure for Implantation
• Room Category
• Facilities availed

However, as compared to the cost of a similar procedure in Western or developed countries, ICD Implantation in India is extremely affordable.

What happens after an implantable cardioverter-defibrillator?

ICD implant procedure in India has performed by highly skilled cardiac surgeons with perfect successful record.

Following the ICD implant procedure, patients are likely to feel drowsy due to the after-effects of anesthesia and experience some inflammation and pain at the site of incision.  You will be required to avoid abrupt movements and refrain from lifting your left arm above shoulder height for 2-3 weeks, as some leads of ICD have placed through the veins into the heart.

Monitoring of cardiac rhythm has done, and in a day or two, you will be able to walk and go home.  You will be required follow up visits to enable your doctor to interpret the interactions for heart with ICD device and understand working of device.

Based on the smooth working of ICD, you will be permitted by your doctor to return to your normal physical activities.

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