Medical Automatic Cardiverter Defibrillator (ICD): What is it, how is it arranged, to whom is recommended? Cardiover defibrillator and pacemaker: What is the difference?

Implanted cardiover defibrillator is a modern device that is installed under the skin. Helps to work to the heart.

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Cardioner Defibrillator (ICD) - This is a device that has become an important element of preventing sudden heart failure in patients from the highest risk groups.

Read on our website an article on the topic: "What tests should be taken to check the heart?".

What are the indications for the implantation of the cardiverter-defibrillator? What is the procedure? What is possible and what can not be people with implanted ICD? Look for answers to these and other questions in the article. Read further.

What is a medical automatic implantable cardiover defibrillator (ICD): What is the difference from a pacemaker and other similar devices?

Medical automatic implantable cardiover defibrillator (ICD) is an electronic device the size of a matchbox. Read more:

The implantable cardiover defibrillator (ICD) has become an important component in preventing sudden heart death in patients from high risk.
The cardiover defibrillator combines the function of electrical stimulation with the so-called high-energy therapy. When there is a sudden, life -threatening ventricular arrhythmia (for example, ventricular tachycardia, ventricular fibrillation), the device radiates moderate discharges, thereby saving the patient's life.

Initially, this device, designed by the Polish physician Mecxiwar Mirovsky, was implanted by the patient in the chest cage, and the procedure was performed by cardiac surgeons. Currently, the most common form of ICD resembles an ordinary pacemaker and consists of an electrode inserted into the heart. The principle of operation of a conventional pacemaker is based on applying a section of the heart of external electrical stimuli, which is produced by the EX, to ensure the normal reduction of the myocardium.

The task of the ICD is to capture the impulses of the “motor” and conduct “therapy” in life -threatening situations. The device is connected, inserted under the skin. It contains a special battery and electronic systems (mini -computer). Such a device can also act as a starter.

Another device of the new generation that performs the same task is completely subcutaneous s-ICD cardiover defibriller. This is a more modern device. Unlike the classic ICD and pacemaker, the electrode of this device does not contact the heart and implants into subcutaneous tissue near the sternum. S-OCD It interrupts arrhythmia, but cannot stimulate the heart. Today, implantation procedures are carried out by cardiologists-electrophysiologists. The cardiover defibrillator (ICD) is effective in stopping ventricular tachycardia and fibrillation.

Subcutaneous cardiover defibrillator (ICD): How does it work?

The implantable subcutaneous cardiover defibrillator (ICD) constantly “monitors” the heart rhythm. How does he work?

When the heart rate is higher than the predetermined and programmed by the doctor (higher than the so -called detection threshold), the device begins to analyze the characteristics of the ECG.
The device determines whether it really deals with ventricular arrhythmia life -threatening. For this, various algorithms are used. Their task is to distinguish severe ventricular arrhythmias from the physiological acceleration of the heart rhythm or less severe supraventricial arrhythmias.
The “detection threshold” can be individually programmed for each patient.
Young people who are engaged in physical exertion leading to the pulse of the pulse, or people with well -known supraventricular arrhythmias, such as atrial fibrillation, as a rule, have a higher “detection limit”.

If the ICB classifies arrhythmia as life -threatening, it begins to prepare for its termination, that is, for the appointment of therapy. It can take the form of an electric shock (cardioversion and defibrillation) or the so -called antitachiary stimulation (ATP), which includes short -term stimulation of the ventricle with a speed slightly exceeding the frequency of arrhythmia. The type of therapy, which will be carried out first of all, each time is programmed by a doctor depending on the individual needs of the patient.

Cardioner Defibrillator (ICD): Indications for installation, who is recommended?

Naturally, the ICD is prescribed by a cardiologist. There must be special indications for this. So, to whom is the device recommended? Here are the testimony:

Patients after a sudden cardiac arrest.
Patients with heart failure with the ejection fraction (FVLS) 40%, which had an episode of severe ventricular arrhythmia (hemodynamically unstable ventricular tachycardia or fainting).
People with postinfarct (ischemic) heart failure of the II/III class, with a low FV LV 35%, a month after myocardial infarction.
Adults with heart failure of class II/III, FVLL 35%, with a low fraction of emission without coronary heart disease (dilatation cardiomyopathy).

The final decision on the implantation of this device is made by the cardiologist after performing the full set of appropriate tests and other diagnostics.

Cardioner Defibrillator (ICD): movement restriction, sports

After the operation, some restrictions for movement apply. Sports is forbidden to play within 6-12 months. It all depends on the type of loads and individual characteristics of the body, as well as on the diagnosis. In addition, professional drivers are not allowed to work. The fact is that the ICD will save the life of the driver, but threaten passengers. All due to the fact that a person can lose legal capacity for a few seconds, and this is dangerous if a person leads a bus or other vehicles with passengers. Read more:

Destruction of movement with a cardiover defibriller

Installation of a cardiover defibrillator: The course of the operation

ICD implantation is usually carried out under local anesthesia. Rarely, for example, in children, the procedure is carried out under general anesthesia. Most patients evaluate the procedure as painless (2-3 points on a 10-point scale, where 10 is severe pain). Sometimes, at the request of the patient, painkillers can be prescribed during the procedure. The course of the operation during the installation of the cardiover defibriller:

First, the doctor anesthetizes the place where implantation will be performed.
The specialist checks the work of the ICD.
Then the doctor performs an incision.
ICD is inserted and the hole is sewn up.
At the end of the procedure, your doctor may decide to conduct the so -called defibrillation test (DFT test).
Its task is to make sure that the implanted device works correctly. The test is carried out under short -term general anesthesia (for the patient’s test, the patient is lifted for 20 minutes).
If the healing procedure is not accompanied by complications, the patient’s stay in the hospital does not exceed 2-3 days.
Complications are rare, but if they still occur, hospitalization is extended to 7-10 days.

Postoperative seams are usually removed on 7-10 days. Depending on the clinic, the patient should appear for verification and final programming of the device after 1-3 months After implantation. The date is appointed by the doctor. During this period, sharp movements of the hands should be avoided. You must also refuse to drive a car. Of course, during this period it is necessary to carefully monitor the wound and inform doctors about any unusual reactions. Can be observed:

A little swelling
Bruise
Soreness in the field of implantation, which remains for one to two months

After this period, the patient should not experience any unpleasant symptoms and discomfort associated with the implanted device.

When to replace the ICD?

The cardiover defibrillator must be replaced when the battery is discharged. A very high battery charge occurs with electric shocks, when the patient, for example, has ventricular arrhythmia - 3 or more discharge per day. During such a sudden, heavy and life -threatening arrhythmia, the device can wear very quickly - within a few days or even hours.

But more often people wear ICD for a long time. Between implantation and replacement of the ICD can take up to 10 years. But this period can be significantly reduced if ventricular arrhythmia and other life -threatening situations concern the patient often. During the entire time of wearing the apparatus, the patient must come for inspection - at least once every 6 months or once a year. The reception date is appointed by the attending physician. If necessary, the “box” of the device with the battery is replaced. The replacement procedure itself is shorter in time than implantation, but still requires 2-3 days of hospitalization.

After the implantation of the ICD and the healing of the postplantation wound, the patient is usually no more limited than during the underlying disease:

A person can drive a car.
ICD implantation is also not a reason for limiting professional activities in most cases, although some professions, such as navigator or professional driver, are not recommended for patients with a similar apparatus.
A patient with an implanted cardiover defibriller can engage in amateur sports. But it is necessary to report this to the doctor so that the doctor can program the device.
Martial arts are not recommended to such people.

There are no restrictions on the use of standard household and electronic devices, including mobile. In the case of high voltage values \u200b\u200bof the electromagnetic field in the working environment of a person with ICD, you must first consult a doctor, and sometimes conduct detailed measurements.

Since some medical procedures are not recommended for patients with ICD, you must inform the doctor who recommends physiotherapy that you have an implanted device. In the past, magnetic resonance imaging in patients with ICD was completely contraindicated. In modern devices, this is possible, but with some restrictions and requires appropriate reprogramming ICD.

Cardiover defibriller implantable single -chamber, two -chamber, three -chamber: reviews

If the doctor has appointed you to install a cardiover defibriller implantable, two -chamber or three -chamber, do not hesitate, then this is vital for you. The installation process takes no more than an hour. Everything is safe and painless for the patient. Here read the reviews of other people:

Lyudmila, 32 years old

Recently I was diagnosed with an elongated QT interval syndrome. The cardiologist immediately advised the cardiover defibrillator so that there was no sudden cardiac arrest. I agreed to the operation right away. The recovery process was good. I took a three -week vacation. There was a little pain and discomfort from the seams, but in general it is not so bad. Now I feel good, I even started playing easy sports - quickly walking, of course, after consulting a doctor. The device does not interfere and is almost not felt.

Mikhail, 45 years old

The device does not somehow affect my life globally. It is simply installed inside me, and I know that in a difficult situation for health, the device will help me. The operation suffered well, does not hurt at all. I don’t know why I was strewn for 15 minutes during the operation, but the doctor said it was so necessary to check something. I continue to engage in merchandising. I know that the cardiverter influenced my family. First of all, my wife and mother calmed down. This is a kind of airbag that carries calm to me and my family.

Alexey, 39 years old

Always playing sports. But one night it became ill, something baked in the chest. In the hospital, the doctor said that a heart attack. After a complete examination, the ICD installation was assigned. Six months have already passed after the operation. Now I go a lot and even try to ride a bicycle. I feel good. My life has not changed, I do everything that I did before the operation, but I know that the ambulance is always there. This is the name of my relatives.