Implantable cardioverter defibrillator (ICD) is a small device placed under the skin to keep track of the heartbeat. A defibrillator implant is useful in preventing sudden death and abrupt cardiac arrest in patients who may not have suffered a heart attack, but are at its risk.
A heart fibrillator surgery can be required in adults, teens and in unfortunate cases, children too. Any cardiologist can recommend defibrillator procedure if an individual suffers from arrhythmia. An ICD pacemaker is very good at treating life-threatening problems, such as ventricular arrhythmias.
Some forms of arrhythmias make the ventricles either quiver frequently or beat too fast. People who have earlier suffered from a ventricular arrhythmia before or had a heart attack that previously damaged the electrical system of the heart are at a higher risk of ventricular arrhythmias in the future.
People who have fortunately survived a sudden cardiac arrest (SCA) are often recommended an ICD pacemaker surgery. Even for those who have specific heart conditions that put them at higher risk for SCA can also be recommended defibrillator procedure. Some of the common causes of arrhythmias include the following:
Some of the noticeable symptoms of arrhythmia include the following:
An ICD pacemaker device monitors the heartbeat at every moment and if required, it delivers an extra beat or gives an electrical shock to restore a normal heart rhythm. Another implantable device may be combined with it to control abnormal heart rhythms.
You should discuss the procedure details with your doctor or surgeon and inform him about your medical history. Inform the doctor if you are pregnant or planning a pregnancy. People with other kinds of blood disorders are usually tested before the procedure.
Apart from all this, separate stress tests may be conducted on the patient. Sensitivity to any medications or to anaesthetic agents, iodine latex, or tape should be informed. Some period of fasting is required before the ICD heart device placement surgery, which shall be instructed by the doctor in advance. You may also be required to take some antibiotics before the procedure. You should discuss the medications you are taking currently to the surgeon prior to the procedure.
The defibrillator procedure can be performed on an outpatient or inpatient basis. Depending on the experience and preference of the doctor, the procedure can slightly vary.
After removal of jewelry and accessories and change into the hospital gown, the patient is required to empty their bladder. An IV line is started in the hand or arm before the procedure so that medicines and fluids can be injected later.
Usually, during the heart defibrillator surgery, the patient is placed on their back on the procedural table. An ECG or EKG is connected to monitor and it records all the electrical activities related to the heart. Vital signs such as breathing rate, blood pressure, heart rate, and oxygen levels in the blood are constantly monitored. In areas where electrode patches are supposed to be placed are cleaned and at times the hair may be shaved or clipped off in some cases. Large electrode pads are placed on both front and back of the chest.
A sedative is administered in the IV to help the patient relax. But the patient will most likely be in his or her senses during the defibrillator procedure. The insertion site is then cleaned with an antiseptic solution and sterile towels and sheets are placed around the area. A local anaesthetic is injected into the skin at the site of insertion. The doctor makes a small incision at the site of insertion. Under the collarbone, a sheath or an introducer is inserted into a blood vessel. This sheath is a plastic tube through which the ICD lead wire is inserted into the blood vessel and later into the heart.
The patient is required to be as still as possible during the procedure so that the catheter does not move out of place or cause any kind of damage to the site of insertion. The lead wire is then introduced into the blood vessel through the introducer. This lead wire will now slowly making its way up to the heart.
Once the lead wire has made its way into the heart, the doctor test them to ensure that it works and serves the purpose. It is highly possible to have multiple lead wires inserted into the blood vessels, depending on the kind of device the doctor has chosen for the patient. To test the location of the leads, fluoroscopy is conducted and the position is checked in the monitor.
Now the ICD generator is slipped under the skin through the point of an incision below the collarbone after the attachment of the lead wire. The generator is placed on the non-dominant side of the body (suppose if the patient is right-handed, then the device is placed on the upper left chest. If the patient is left-handed, the device is placed in the upper right chest). The ECG that was earlier mentioned keeps monitoring the function of the ICD and tests can be performed to assess the functioning of the device. The incision in the skin is closed with the help of a special glue or adhesive strips and a sterile bandage dressing is applied to the site.
The patient is closely monitored before the surgery and it is necessary to inform about any discomfort that is felt after AICD placement. Some amount of chest pain is normal. Vital signs are monitored and the easily digestible food is given for a few days.You will be discharged when the breathing and heart rate stabilizes. Within a few weeks or so, you can resume a normal life with some restrictions on movement as advised by the doctor. Driving has to be avoided until the doctor approves of it.
Specific instruction has to be followed regarding bathing and dressing. Regular evaluation of ICD is required at a certain frequency. A duly filled card will be given at the time of discharge, which must be carried by you. You must inform the security personnel during airport screening or mall screening that you have an ICD installed. You must also avoid being close to heavy motors or strong magnetic and electromagnetic fields.
You must notify your doctor if you feel feverish, palpitations, or have severe chest pain during the recovery period or at any point of time. You must discard completely discard the habit of carrying the mobile in your chest pocket.
Q: Will ICD completely cure the heart rhythm problems?
A: No, it cannot treat the problem permanently
Q: How often does the doctor check the ICD?
A: Depending upon the intensity of the patient’s problem, the checkup can vary from 2 months to 4 months and in some cases even 6 months.
Q: What is the cost of ICD?
A: Implantable cardioverter defibrillator cost can vary from $30000 to $50000 in the Western countries. But the ICD heart device cost in India and other medical tourism destinations is much less than the Western countries.
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