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Implantable Cardioverter Defibrillator
What is it
ICD (Implantable Cardioverter Defibrillator) is an electronic device,
which has very advanced cardiac rhythm monitoring system. The device can
diagnose various rhythm disorders of heart, and deliver a preprogrammed
therapy for specific arrhythmias. These therapies include pacing or delivery
of a DC shock to terminate dangerous arrhythmias. The device has a built-in
pacemaker, which can take care of slow heart rhythms also should the patient
need it.
Why is it done?
Implantation of the ICD is done in patients who suffer from very fast
arrhythmias. These rhythm disorders are often associated with dizziness,
or fainting and can be life-threatening. ICD can diagnose these rhythm
disorders by a very sophisticated arrhythmia detection algorithm, and
then deliver appropriate therapy. If the arrhythmia is less dangerous,
initially ICD tries to terminate it by overdrive pacing. If this is not
effective, or if the arrhythmia is very dangerous in nature, a DC shock
with appropriate energy is delivered which normalizes the heart rhythm
in virtually all cases.
How to avail?
If anyone suffers from fast palpitations, or dizziness, or fainting spells,
he or she should be brought urgently to the hospital where monitoring
of heart rhythm and accurate diagnosis can be done. If the rhythm disorder
requires placement of ICD, it can be done while the patient is in hospital.
How is it done?
The ICD is implanted in a special sterile room called 'Electrophysiology
Laboratory' under local anesthesia, while the patient lies on the operating
table fully conscious, though under mild sedation. Deeper sedation is
used for brief periods for testing of the device. In almost all cases,
the ICD is implanted on the front of the chest under the clavicle (collar
bone) on left or right side. This is done thru a small incision of about
5 cm. One or two pacing/defibrillation leads are placed inside the heart
thru a vein, and are connected to the device.
Before ... Precautions &
prerequisites
An ECG, chest X-ray, and certain blood tests are done before the procedure
to rule out infection and to check blood-clotting parameters. The patient
is admitted to hospital before the procedure, and then taken to the laboratory
after preparation of the implantation area which includes cleaning and
shaving of the front of the chest.
After
After the procedure, patient is taken to the intensive care unit where
monitoring of rhythm is done for a day. Subsequently patient is shifted
to the ward room for 2 or 3 days. Dressing of the implant site is done
after 48 hours and few more times in the next one week. Patients are normally
discharged from hospital after 3-4 days of ICD implantation.
Tariff
The cost of the ICD depends on the appropriate device for the patient, and varies from Rs 450000 to 900000.
Procedure Fee Rs 50,000
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