Implantable Defibrillators Allow Cardiac Patients to Lead Healthier, More Active Lives
Common Questions About Implantable Cardioverter Defibrillators
Q:Who is a candidate for an Implantable Cardioverter Defibrillator (ICD)?
A:Patients who have experienced a heart attack, who experience extra heartbeats or have heart disease that may result in abnormal heart rhythm.
Q:What does an ICD do?
A:An ICD monitors a patient's heart rhythm and delivers corrective electrical pulses, based upon disturbances it detects.
Q:How is an ICD implanted?
A:Using local anesthesia and sedation, the device is implanted under the skin, most commonly in the upper chest.
Q:How long does the procedure take?
A:The procedure takes approximately 45 minutes, with an overnight stay in the hospital.
Q:What follow-up care is required?
A:Every two to four months, an outpatient visit is required to perform non-invasive testing on the device and its performance.
September 2003 — The choice to undergo surgery is significant for both patient and family. However, when surgery presents the opportunity for improved quality of life, or even prolonged life, the choice is easier to make.
Such is the case for patients who have suffered, or are at risk of suffering, serious abnormal heart rhythms that most often result from a damaged heart. Fortunately, a relatively simple procedure involving the implant of a device just below the skin's surface may help increase survival in these patients.
Identifying Candidates
"Each year, approximately 350,000 people die from a sudden cardiac death event," says Raul Mitrani, MD, Director of Cardiac Electrophysiology at Memorial Regional Hospital and physician on the medical staff at Joe DiMaggio's Children's Hospital and Memorial West Hospital. "Of that population, 75 percent have survived a previous heart attack or have risk factors indicating the potential for a sudden cardiac event."
"By testing these individuals, either non-invasively or invasively, we can identify appropriate candidates for an Implantable Cardioverter Defibrillator, or ICD," says Dr. Mitrani.
According to Dr. Mitrani, the ICD monitors the heart's rhythm and delivers electrical pulses, or shocks, when the rhythm is too rapid and sustained. These shocks are delivered by thin wires that run through veins from the heart to the implanted device.
"Imagine the cardiac heart paddles used by paramedics or in the emergency room. The ICD performs the same action when it detects abnormal rhythm; however, it is implanted and monitors heart rhythm on a consistent basis, delivering corrective action immediately."
While the ICD monitors for abnormally rapid heart rhythm, it also works like a pacemaker to raise the rhythm if it is detected to be too slow.
Safe Surgery
Similar to a pacemaker procedure, ICD surgery is relatively simple and safe. A fairly small device is implanted under the skin, usually in the chest, using local anesthesia and light sedation.
The procedure generally takes less than an hour and typically involves an overnight hospital stay. Most patients may return to normal activity within a week or two.
Follow-Up Care
Patients with ICDs will be scheduled for periodic outpatient visits every two to four months, depending on their situation. During these visits, physicians apply a programming wand over the implant site (non-invasively) that communicates with the device via electromagnetic waves. This test helps to evaluate what rhythm disturbances have been detected, what electrical treatments have been delivered and if any adjustments are required.
For referral to a physician or cardiologist, please call the Memorial Healthcare System Physician Referral Service at (800) 944-DOCS.