Implantable Cardioverter Defibrillator (ICD)

Introduction

An Implantable Cardioverter Defibrillator (ICD) is a medical device used to monitor and correct life-threatening heart rhythm disturbances. It is particularly effective in preventing sudden cardiac arrest (SCA) in patients at high risk.

How Does an ICD Work?

An ICD is implanted under the skin, typically below the collarbone. It consists of: - A pulse generator (battery and electronic circuits) - Leads (wires) that go into the heart to detect abnormal rhythms

When the ICD detects a dangerous arrhythmia, it can: 1. Deliver small electrical impulses to correct mild abnormalities. 2. Administer a strong shock to restore a normal rhythm if needed.

Who Needs an ICD?

ICDs are recommended for people who: - Have survived a sudden cardiac arrest - Have a history of ventricular arrhythmias - Have a weakened heart due to conditions like heart failure or cardiomyopathy - Are at high risk due to inherited conditions like Long QT syndrome

Risks and Benefits

Benefits:

  • Prevents sudden cardiac death
  • Continuously monitors and treats dangerous arrhythmias
  • Improves survival rates in high-risk patients

Risks:

  • Possible infection at the implant site
  • Battery depletion requiring replacement surgery
  • Unnecessary shocks in some cases

Conclusion

For patients at risk of life-threatening arrhythmias, an ICD can be a lifesaving device. However, it is important to discuss the risks and benefits with a cardiologist.

Source recommendations

1. American Heart Association Guidelines on Implantable Cardioverter Defibrillators

  1. https://www.heart.org/en/health-topics/arrhythmia/prevention--treatment-of-arrhythmia/implantable-cardioverter-defibrillator-icd
  2. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
  3. https://www.heart.org/en/health-topics/arrhythmia/prevention--treatment-of-arrhythmia/living-with-your-implantable-cardioverter-defibrillator-icd
  4. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063
  5. https://pubmed.ncbi.nlm.nih.gov/23008437/

2. European Society of Cardiology Guidelines on Sudden Cardiac Death Prevention

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Ventricular-Arrhythmias-and-the-Prevention-of-Sudden-Cardiac-Death
  2. https://academic.oup.com/eurheartj/article/43/40/3997/6675633
  3. https://pubmed.ncbi.nlm.nih.gov/29191938/
  4. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
  5. https://pubmed.ncbi.nlm.nih.gov/36017572/

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