Implantable Cardioverter Defibrillator- Types, Risks, Preparations, and Precautions

Introduction

An implantable cardioverter-defibrillator is a tiny device powered by a battery and placed inside the chest. The primary function of an implantable cardioverter-defibrillator is to detect any abnormality in the cardiac heartbeat. In addition to this, it also helps in controlling and correcting irregular heartbeats known as arrhythmias. Tachycardia is a condition where the heartbeat is extremely fast; on the other hand, bradycardia is a condition where the heartbeat is extremely slow.

An implantable cardioverter-defibrillator monitors the heartbeat on a continuous flow and delivers an electric shock to the heart whenever necessary in order to reset the heart and release regular heart rhythm. An implantable cardioverter-defibrillator is suggested when the patient has a dangerously high heart rate that may lead to heart weakness and cardiac arrest. Ventricular tachycardia or ventricular fibrillation are some of the conditions that may cause a high risk to the patient's cardiovascular output.

What Are the Types of Implantable Cardioverter Defibrillators?

An implantable cardioverter-defibrillator or ICD is generally of two types. This cardiac therapy device comes traditionally or subcutaneously. A conventional implantable cardioverter-defibrillator is implanted within the chest cavity, and lead or wires are attached to the heart. Traditional implantable cardioverter-defibrillator is a highly invasive surgical procedure. On the other hand, a subcutaneous implantable cardioverter-defibrillator is another option where the device is placed under the skin of the chest or the skin of the armpit. This is then attached to an electrode that runs below the breastbone. Subcutaneous implantable cardioverter defibrillators are larger in size than traditional cardioverter defibrillators, but the difference is that subcutaneous implantable cardioverter defibrillators do not attach themselves to the heart.

When Is Implantable Cardioverter Defibrillator Suggested?

There are many reasons why the healthcare provider may suggest an implantable cardioverter-defibrillator. One of the main reasons is to instantly correct irregular heartbeats, whether it is too fast or too slow. In addition, keeping cardiac arrest or heart attack at bay is one of the main reasons to choose an implantable cardioverter-defibrillator.

Mentioned below are a few conditions where an implantable cardioverter-defibrillator may be suggested.

• Frequent episodes of ventricular tachycardia.

• Frequent episodes of fainting.

• Survival of a cardiac arrest.

• History of coronary artery disease.

• History of a heart attack.

• Weak muscles of the heart.

• Abnormal and enlargement of the heart.

• Long QT syndrome.

• Congenital heart disorders.

• Structural defects of the heart.

• Atherosclerosis.

• Damage to blood vessels of the heart.

• Ventricular fibrillation.

What Are the Risks of Implantable Cardioverter Defibrillators?

Risks and complications are a part of every treatment modality when concerned with the cardiovascular system. Nevertheless, the risks of implantable cardioverter-defibrillators are quite a few, and if handled by a correct and experienced professional, these risks can be avoided easily. Mentioned below are a few of the risks and complications that have been documented regarding implantable cardioverter defibrillators.

• Infection at the implant site.

• Swelling.

• Bleeding.

• Bruising.

• Blood vessel damage.

• Bleeding around the heart.

• Blood leaking through the heart valve.

• Collapsed lung.

• Cardiac perforation.

How to Prepare for an Implantable Cardioverter Defibrillator?

The healthcare provider will request the patient and several tests and clinical procedures before suggesting an implantable cardioverter-defibrillator. This is because the healthcare provider and the team need to make sure the patient is a good candidate for an implantable cardioverter-defibrillator and the prognosis is favorable. If there are any undesired results in any of the below-mentioned diagnostic tests, an implantable cardioverter-defibrillator is not advised, and another treatment modality is looked forward to. Additionally, it is also vital for the patient to inform the health care provider of a complete history of drugs and medical conditions as well as any family history of cardiovascular disease.

• Electrocardiography is to measure the electrical conduction system of the heart.

• Echocardiography is a type of heart ultrasound to give a complete picture of the heart structure.

• Holter monitoring is a device that tracks the heart's rhythm and wants the health care provider about any signs and symptoms of a cardiac arrest. This is a wearable device that can be worn for two days.

• Event recorder or Holter monitor.

• An electrophysiology study is done to study the structures of the blood vessels of the heart and other features such as the conduction system, muscles, and cardiac output.

What Are the Long-Term Precautions of Implantable Cardioverter Defibrillators?

An interference of electrical conduction due to an implantable cardioverter-defibrillator may have a few chances to develop but still is rare. Mentioned below are a few of the precautions that the patient needs to follow on a long-term basis for the implantable cardioverter-defibrillator to work with maximum efficiency.

• Mobile phones and other cellular devices should be kept six inches apart from the heart because the signal of the mobile and the signals of the implantable cardioverter-defibrillator interfere with each other and lead to sudden fatigue and loss of consciousness in the patient.

• Metal hand detectors should not be allowed for more than 30 seconds around the chest or the implantable cardioverter-defibrillator. It is always advised to the patient while traveling to carry the medical report of the presence of an implantable cardioverter-defibrillator to avoid any customs issues.

• Diagnostic procedures such as magnetic resonance imaging and computed tomography should be avoided or kept at bay. Nevertheless, the best person to decide is the health care provider. That is why it is a must for every patient having an implantable cardioverter-defibrillator to inform the professional about the presence of this device.

• It is advised to stand at a minimum of two feet from the power generator, welding pieces of equipment, high voltage transformer, or other motor-generator systems if the patient works around such equipment.

• Headphones may contain magnetic substances that may interfere with an implantable cardioverter-defibrillator. It is advised to keep headphones at a distance of six inches from the implantable cardioverter-defibrillator.

• Wireless chargers and electronic devices should also be kept at about 15 centimeters distance from the implantable cardioverter-defibrillator.

• Magnetic induction of any sort may interfere with the implantable cardioverter-defibrillator. It is wise to avoid using magnets or maintain a six-inch distance from the site of the implantable cardioverter-defibrillator.

• Devices such as toasters, electric shavers, electric drill scanners, printers, radius computers, televisions, microwave ovens, remote controls, and electric blankets force little to no risk to an implantable cardioverter-defibrillator. The healthcare provider will give a detailed list of the risk factors and machinery that has to be avoided by the patient who has undergone the procedure of an implantable cardioverter-defibrillator.

Conclusion

An implantable cardioverter-defibrillator is a device that may be used in an emergency setup or scheduled appointment by the health care provider. An implantable cardioverter-defibrillator is used to reset the heart suffering from an irregular heartbeat, cardiac arrest, or episodes of a heart attack. The procedure is relatively quick, and the outcomes are generally good. Patients need to follow the instructions provided by the health care provider, and the team post an implantable cardioverter-defibrillator for the long life of the machine and good health of the cardiovascular system. Patients are allowed to live a fully functional life and continue with their day-to-day activities after a week of treatment with an implantable cardioverter-defibrillator.