Automatic Implantable Defibrillator

What is the automatic implantable defibrillator?

It is a device similar to a pacemaker that detects not only the stimulus of the heart chambers, but also the different types of tachycardias.

The defibrillator has two parts: the generator and the electrodes. In the case of the automatic defibrillator, the generator is larger than other pacemakers, as it includes an energy transformer. The electrodes stimulate and detect the heart’s activity. They deliver a shock when they measure a tachycardia according to certain previously defined variables.

What is it used for?

When a defibrillator is implanted, the aim is to control the number and duration of tachycardias of ventricular origin. The aim is to prevent complications arising from this pathology, such as sudden death. This treatment can be used for primary prevention, in patients who have never suffered an episode of sudden death, or for secondary prevention, to prevent its recurrence.
As for primary prevention, defibrillation is usually indicated in people who, although they have not suffered a previous episode, have been diagnosed with channelopathies, cardiomyopathies or congenital heart disease.

What does the treatment consist of?

There are different ways of implanting a defibrillator:
– Endovenous: it is introduced through a subclavian vein to reach the ventricle of the heart.
– Epicardial: intended for patients with vascular problems or anatomy that makes vascular access difficult. The generator is installed in the abdomen.
– Subcutaneous: the electrode is placed under the skin.

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Once installed, the device can detect and analyze possible tachycardias. If it does so, two types of therapy are administered: antitachycardia therapy, which controls the abnormality, and defibrillation therapy, which interrupts the arrhythmia and restores normal rhythm.

How should I prepare?

No preparation is necessary prior to implantation of an automatic defibrillator.

Care of the automatic implantable defibrillator

The implanted automatic defibrillator requires check-ups every 6 months, where everything is analyzed to ensure that everything is working correctly. The patient is able to lead a normal life and perform any physical exercise he/she wishes.
However, as it is an electrical device, there are some recommendations and care that are important to avoid damaging the device. For example, the cell phone should be kept away from the area where the defibrillator is implanted and a certificate should be presented at the airport to avoid going through the metal detector control. In addition, care should be taken and specialists should be warned before treatments such as magnetic resonance imaging, radiotherapy or cauterization with an electric scalpel.