A single chamber ICD has a platform in the right ventricle of the heart. The ICD transmits energy to the ventral, when required, to maintain a natural rhythm of the heart. An ICD is a portable system that battery-powered in the chest for the control of heart rates and heartbeats. It measures audiometric defibrillation. An ICD can induce mild electrical shocks through one or more heart-related wires to repair an erratic heart rhythm.

Why do we need an ICD and when?

  • Heartbeat (ventricular tachycardia) dangerously fast.
  • A chaotic heartbeat which prevents the cardiovascular fibrillation of the patient from providing the rest of the body with sufficient blood
  • Heartbeats irregular (arrhythmias).

ICDs identify arrhythmias and interrupt them. The unit tracks heartbeat constantly and provides electrical pulse as required to restock natural heart rhythm. An ICD varies from a pacemaker – an implantable system used to monitor irregular beats of the heart.

Procedure

A battery-powered pulse generator is implanted in a pouch under the skin of the chest or abdomen, sometimes below the collarbone. The generator size is about the size of a pocket watch. There are wires or leads which run from the pulse generator into locations on the heart’s surface or in the heart and can be inserted through the blood vessels so that open chest surgery is removed.

How is it performed in B. P. Poddar?

In the event of a rapid heartbeat, the cables from the heart to the machine relay signals to the ICD to control the heartbeat by transmitting electric pulses. The ICD may be coded for the following depending on the problem:

Low energy pacing: When ICD responds to moderate pulse fluctuations the patient can not experience any or no painless flutter in the chest.

A more energetic shock: The ICD will lead to an increased energy shock to more severe heart rhythm issues. This shock may be intense, and you can feel as if you were kicked into the face. The pain generally just takes a second, and once the shock stops, there should be no pressure.

In general, only one shock is required to restore a natural heartbeat. However, often within a 24-hour cycle, you can feel two or three shocks.

It is classified as an electric or arrhythmia storm that has three or more shocks in a short period. When that happens, you have to look for medical treatment to scan for an ICD deficiency or if you have a heart attack that abnormally hits you. The ICD may be modified if necessary to decrease shock numbers and frequencies. You may need extra drugs to beat the heart consistently and reduce the risk of an ICD storm.

An ICD may also monitor the movement and rhythm shifts of the heart. This knowledge assists the doctor in calculating the rhythm and reprogramming ICD if necessary. To prescribe one of the following forms of ICDs, a cardiologist can recommend a patient:

  • One ICD (sends electric signals to the right ventricle) with one-chamber.
  • A dual-camera ICD (transmission of electric signals to the right ventricle and atrium).
  • A biventricular system (sends electrical impulses and all ventricles to the right atrium). Doctors use it on patients with cardiac insufficiency.

Up to four kinds of electrical signals can also be sent to the heart:

  1. Cardioversion: Cardioversion gives a powerful electrical signal which can sound like a chest thump. When a very high heart rate is observed, it resets heart rhythms to normal.
  2. Defibrillation: Defibrillation sends a very effective electric message restarting the heart. The feeling is uncomfortable and will sweep you off your feet, but lasts only for a second.
  3. Antitachycardia: Antitachycardia pacing gives a low-energy pulse to reset a fast pulse. Normally, when the pulse happens, the patient senses nothing. But a slight flood in the chest could be felt.
  4. Bradycardia: Bradycardia is a pulse that is too sluggish to regain normal rhythm. The ICD behaves as a pacemaker in this case. ICD patients generally get heart pounding too rapidly. Defibrillation can, however, often slow the heart down to a dangerous degree. The pace returns to normal with Bradycardia’s timing.