An Implant Cardiac Defibrillator (ICD) is a pager-size device that is placed in the chest of a patient suffering from heartbeat ailments. If the patient’s lower heart chambers (ventricles) go in a dangerous rhythm or stop beating due to cardiac arrest, the patient might need an ICD implant. It is also required by patients who have a fatally fast heartbeat (called ventricular tachycardia) or in the case of a chaotic heartbeat that might not allow the heart to supply enough blood to the other parts of the body (ventricular fibrillation). The device detects abnormal heartbeats and stops arrhythmias while continuously monitoring the heartbeat. It also helps in restoring a normal heart rhythm when necessary by delivering electrical pulses. This device is different from a pacemaker. It is the size of a pack of playing cards and contains a small box with a computer and a battery. The device is programmed to give a shock if the heart rate exceeds the given figure for more than a stipulated amount of time. If your heart rhythm becomes erratic, you may faint and wake up when the device has given a shock.
A patient suffering from ventricular tachycardia will be an ideal candidate for a defibrillator surgery procedure. You will be a candidate for this surgery if you have survived a cardiac arrest or might have fainted due to a ventricular arrhythmia. You can also benefit from this procedure if you have:
• A medical history of coronary artery disease
• A heart attack that might have weakened your heart
• A specific heart condition which involves an abnormality of the heart muscles. This includes enlarged (dilated cardiomyopathy) muscles or thickened (hypertrophic cardiomyopathy) muscles of the heart.
• A genetic defect that makes your heart beat abnormally. This includes the QT syndrome, which causes ventricular fibrillation and can lead to death in youngsters without showing any signs or symptoms
• Other rare conditions like Brugada syndrome or arrhythmogenic right ventricular dysplasia If you are facing any of the above problems, it might be time to consult our cardiac surgeons at the earliest and start the process for an ICD implant.
In order to determine whether you are the right candidate for an ICD implantation procedure, your doctor will recommend a series of tests including:
• ECG – The heart’s beating pattern will offer clues to the kind of irregular heartbeat you might be suffering from.
• Echocardiography – This procedure allows the doctor to see your heart without making an incision. It composes images of your beating heart on the monitor so that the doctor can measure the thickness and size of the heart muscle.
• Holter Monitoring – This device monitors your heartbeat for 24 hours and the findings help the doctor in the right prognosis.
• Electrophysiology study (EPS) – The doctor will guide electrodes from the blood vessels to your heart in order to properly test the functioning of the heart’s electrical system. This helps doctors identify potential risks of heart rhythm problems.
The procedure is usually done under local anaesthesia and lasts for about two hours. During the surgery, the surgeon will insert one or more flexible insulated wires into the veins near your collarbone. These are guided to your heart with the help of X-ray images. These wires have leads at the end that are secured to your heart and the other ends are attached to the device generator which is placed under the skin below your collarbone. Before the surgery is completed, the doctor will test to see if the ICD is working properly. This might require shocking your heart and thus, a general anaesthesia might be given. He will also program the device to work correctly based on your particular heart problem. Once the results are positive, the doctor will close the wound with sutures and apply a small dressing.
You might have to stay in the hospital for a day or two after the surgery. The doctor will test the ICD to ensure the implantation has worked. You do not need to undergo another surgery to additionally test the implantation of ICD. You can’t drive for about a week after the procedure and need to take extra care of your mind and body. You can start taking short walks or any other mild physical activity to recover faster after the surgery. Normally, complete recovery takes about 12 weeks.
RISK AND COMPLICATIONS
A cardiac defibrillator implant procedure brings some risks to the patient but when weighed against the benefits, the complications are comparatively lower. Some of the commonly known risks of this surgery include:
• Infection in the area where the device is implanted
• Swelling, bruising or bleeding at the implanted site
• In rare cases, bleeding around the heart which can be life-threatening
• Blood leakage from the heart valve where the ICD lead is present
• Severe damage to the veins where the ICD lead is placed
• Allergic reactions to the medicines given during the procedure of ICD
• Pneumothorax, lung collapse
Due to the capabilities and advantages of an ICD implant procedure, it is increasingly becoming a standard treatment for patients who have suffered a cardiac arrest. It is also a great solution for patients who might be at a high risk of sudden cardiac arrest. Patients with an implant are at a lower risk of sudden death from cardiac arrest compared to those who only take medications to regulate their heartbeats. Normally, patients who have an ICD will have to keep it for their lifetime. The cost of ICD implant starts at Rs. 2.5 lakhs in India and it largely depends on the patient’s choice of hospital and doctors. There are many hospitals all over India that offer state-of-the-art treatment for ICD at extremely affordable costs. Since the defibrillator implant cost is low in India, many global patients choose to conduct their surgery in the India and return once they recover. If you have any further questions about the surgery or the pricing, please feel free to contact our doctors any time at +91-9999332093