Implantable cardioverter defibrillators (ICD), or simply just defibrillators are devices that are designed primarily to carry out anti-tachyarrhythmia therapy (tachyarrhythmimia and tachyarrhythmia therapy will be explained in next articles). ICD is a device used to detect and instantly stop the malignant heart rhythm disorders. The system consists of a housing containing a battery and electronic circuit and a catheter containing electrodes that are placed in the heart. This process is known as implantable cardioverter defibrillator defibrillation. Implantable cardioverter defibrillator’s housing is placed under the skin in the area under the (usually left) clavicle. What kind of defibrillator a patient will get and how it will be set primarily depends on patient’s medical history, physical condition, condition of heart and a condition of cardiac muscle cells.
Implantable cardioverter defibrillator can instantly recognize a heart rhythm disorder (most often it is an accelerated working ventricular – ventricular tachycardia or heart flutter – ventricular fibrillation) and immediately respond to with stimulation (by pulses that interrupt rapid heartbeat) or with an electrical shock (by defibrillation). The success of Implantable cardioverter defibrillation intervention is very high, above 98%. In addition, the ICD serves as a “normal” electrostimulator, pacemaker, and its intervention can prevent slow beats.
In addition to therapeutic intervention, the ICD’s memory stores a series of data on the rhythm of the patient, which allows further treatment options (correction of drug therapy – aspirin, the procedure known as “Ablation”, the programming of the device, etc.). Implantable cardioverter defibrillator operates continuously, 24 hours a day. The ICD’s placement surgery procedure is same as cardiac pacemaker surgery and biventricular pacemaker surgery procedure.
Implantable Cardioverter Defibrillator Surgery
ICD placing (defibrillation) is a small surgical procedure under local anesthesia. Surgery is in place for this specialized, electrophysiological laboratories. Before surgery patient intravenously gets an antibiotic and an anesthetic. The implantable cardioverter defibrillator surgery is done under the full awareness of a patient.
On a leg groin incision is made to enter into a vein through which the wire is placed in the heart while a generator is placed below the collarbone with a small incision. Then wires and generator are connected. At the end of the installation the patient is pun under the general anesthesia in order to test the ability of the device to stop malicious rhythm disturbance, ventricular fibrillation. By testing device, ventricular fibrillation is manually caused, the device recognizes and interrupts it. A patient can typically go home the next day. For precautions on this matter you can educate yourself on Blood Types and ABO blood group system article.
The device control is performed at certain intervals (every 6 months) or after the patient noticed an intervention (electric shock most people can recognize good).
Some patients with heart failure may benefit from a combination of cardiac resynchronization therapy (CRT) and an implantable cardiac defibrillator (ICD). These devices combine biventricular pacing with anti-tachycardia pacing and internal defibrillators to deliver treatment as needed.