The implantation of an internal defibrillator is a technique that is usually performed under general anesthesia. Through an incision located in the left clavicle, a vein is located through which the electrode is inserted, with two coils, one at the tip and the other in the middle of the electrode.
The proximal end is then connected to the generator, which includes the battery and the circuitry responsible for the defibrillator’s operation, and is housed under the pectoral muscle.
Which patients are suitable for the internal defibrillator?
The aim of installing an implantable cardioverter defibrillator (ICD) is to prevent sudden death of the patient due to ventricular fibrillation. In this situation, the heart, and more specifically its left ventricle, beats rapidly, disorderly and superficially, and is therefore ineffective in sending blood to the rest of the body.
It has been shown that the ICD prevents sudden death in patients with a very compromised cardiac contraction and who have either had a myocardial infarction or have a heart muscle disease that causes it to dilate too much. This is what we call primary prevention.
Secondary prevention consists of implanting an ICD to prevent sudden death in patients who have already suffered an episode of fibrillation or malignant ventricular arrhythmia. It is indicated in patients who have had a myocardial infarction or who have certain cardiac diseases.
What kind of life and care will the patient have to follow after the procedure?
The limitation will be imposed by the patient’s underlying disease. In addition, after the intervention, the surgical wound must be healed for the first few days until it heals. The patient should avoid magnetic fields, as the defibrillator is a metallic device with a sensitive circuit inside.
After implantation, the Cardiac Surgery expert gives the patient an explanatory leaflet indicating the precautions to be taken into account. Periodically, once a year, the patient should visit the doctor to check the device and the battery life.
What are the risks involved in this procedure?
Nowadays the risks are minimal as long as it is performed by expert hands. Even so, any intervention has some risks that in any case are always lower than not implanting the device.