Implantable Cardioverter-Defibrillators (ICDs) – Preparation, Benefits, Risks, Impact
In ICD implant surgery, ICD or implantable cardioverter defibrillators are implanted to combat Ventricular fibrillation (VF); which is a life-threatening fast heartbeat disorder.
When a person goes through ventricular fibrillation, the lower chambers of the heart don’t contracts normally. They follow an uncoordinated beating pattern and refrains the heart to pump blood effectively. This condition may lead to extreme low blood pressure and cardiac arrest as well. This is where, ICD surgery becomes crucial.
What are Implantable Cardioverter Defibrillators (ICDs)
Implantable Cardioverter Defibrillators is a small battery-powered cardiac therapy device which detects and stops irregular rhythm of heart or arrhythmias after an ICD implant surgery.
It is placed in the chest of a patient; afterwards, it monitors the heartbeat and releases electric shocks to regular heartbeat whenever needed.
One should not confuse it with pacemaker. A pacemaker is used to prevent dangerous slow heartbeats whereas ICD surgery deals with hyper fast heartbeats.
Types of ICDs
There are two basic types of Implantable cardioverter defibrillators (ICDs):
- Traditional ICD: This is placed in the chest and wires, called leads are passed through veins and are attached to the heart.
- Subcutaneous ICD (S-ICD): This is placed under the skin at the side of the chest below the armpit. S-ISCD is not attached directly to the heart, instead it is attached to an electrode, a sensor which runs along the breast/chest bone.
Why ICD implant surgery is done
ICD surgery regulates dangerous irregular heartbeats and corrects them. In the following cases, it acts as the best resort when:
- All heart activities stops all of a sudden, i.e. cardiac arrest
- Cardiac arrest has happened in the past
- A patient is deemed to be prone to have a cardiac arrest
- Heart muscle is enlarged and weak despite treatment
In all the above cases, ICD implant surgery can prevent or reduce the risk of sudden death due to cardiac arrest. Thus, it is preferred over medicines alone.
Doctors may recommend ICD implant surgery in UAE if patients have any of the following symptoms:
- Symptoms of sustained ventricular tachycardia or irregular heartbeat, such as fainting
- Genetic heart conditions such as long QT syndrome which often raises the risk of irregular heartbeats
Preparing for an ICD implant surgery
Doctor recommends ICD surgery in UAE after carrying out multiple tests including:
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Event Monitoring:Anyone going for an ICD surgery should wear an event monitor which is a portable ECG device for up to 30 days or until they have arrhythmia or symptoms like fainting.
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Halter Monitoring:Patients should wear holter monitor, a small medical device that tracks the heartbeat for 1-2 days. It can spot irregular rhythms of heart that may go unnoticed in an ECG.One can carry them in pockets or belts. Wires from the sensors stick to the chest. It has a battery-run recording device. Doctors may ask the patient to note their symptoms during different activities. Patient notes are often compared to the device data for detailed analysis of health condition.
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Electrophysiology/ EP Study:It can diagnose fast heartbeat and find the specific area in patient’s heart which causes fast heartbeat. One or more than one catheter which is a flexible tube is guided through blood vessel into the heart to record heart signals through the sensors on its tips.
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4. Echocardiogram:It is an imaging test which creates moving pictures of the heart with the help of sound waves. An echocardiogram shows the structure and size of heart and blood flow as well.
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Electrocardiogram/ ECG or EKG:• It is painless test to check the heartbeat. Healthcare professional put sticky patches (electrodes) on the chest, arms and legs. They are connected to computer through wires. The results of ECG displays on the computer screen and help doctors to determine whether the heartbeat is too slow or too fast.
Risks associated with ICD implant surgery
ICD surgeries are generally safe and effective, however, just like any medical procedure it also some potential risks. They are as follows:
- Bruising
- Wire Movement
- Lung Collapse
- Infection at implant area
- Blood Leakage (Blood may leak through the heart valve)
- Bleeding (In case there is bleeding around the heart it can be fatal)
- Perforation of the heart (Due to movement of ICD – Extremely Rare)
Post ICD Surgery Care
After an internal cardiac defibrillator in UAE, you need regular check up for heart and the ICD, generally, once in 3-6 months.
The battery inside ICD lasts for normally for more than 10 years. When it starts draining your doctor will have to replace the generator with a new one via a minor surgery which allows the patients to go home the same or following day.
The intervals of checkups are specified by qualified doctors on the basis of certain factors. Patients must report to the doctor if they feel or notice anything unusual about their health and shocks from the ICD.
Generally, these shocks mean the cardiac therapy device is treating a heartbeat condition and protecting the human against cardiac arrest, however, it is still advised to inform healthcare professionals about their occurrence.
ICD surgery and Terminal Illness
In case a person has an ICD and gets terminally ill, the ICD may keep delivering shocks. Hence, doctors or healthcare professional turn off the device through a simple reprogramming if required.
Turning off implantable cardioverter-defibrillators (ICD) will not instantly cause the heart to stop instead it stops unwanted shock and further suffering during a chronic illness. This is however a near the end-of-life issue for which patients should take medical decision after receiving ample professional advice.
These were some brief information about ICD implant surgery. To read more articles related to cardiology, keep visiting The Heart.ae. If you have been advised an ICD surgery or diagnosed with cardiac issues, you can consult Dr Moutaz El Kadri, a veteran cardiologist & electrophysiologist. He has been treating patients with complex cardiac ailments and issues for more than a decade; your health will stay in the safest hands.
FAQs
What is the difference between a pacemaker and an ICD?
A pacemaker helps regulate slow heartbeats, while an ICD detects and corrects dangerously fast or irregular heart rhythms by delivering shocks.
Is ICD implant surgery painful or risky?
ICD implant surgery is generally safe with minimal pain, but potential risks include infection, bleeding, or device-related issues such as lead displacement.
How long does an ICD battery last, and what happens when it runs low?
The battery typically lasts 7–10 years. When it runs low, the generator is replaced in a minor outpatient procedure.
Can I live a normal life with an ICD?
Yes, most patients resume normal activities with some precautions. Regular checkups ensure the device functions correctly and protects your heart effectively.
