This is sometimes called a biventricular ICD. A biventricular pacemaker and ICD is a small, lightweight device powered by batteries. This device helps keep your heart pumping normally. It also protects you from dangerous heart rhythms. Read on to learn more about this device and how it works. The heart is made up of 4 sections chambers that pump to move blood through the heart. The top 2 chambers are the left atrium and right atrium.
These are filling chambers of the heart. The bottom chambers are the left ventricle and right ventricle. These are the pumping chambers of the heart. The heart has an electrical system. This system sends signals that make the atria and ventricles work together. This causes the heart to beat and move blood through the heart and lungs and out to the body. Heart failure weakens your heart muscle. The pathways that carry the heart's electrical signals are located in the heart muscle.
They can also be damaged by CHF. This can cause a bundle branch block. A bundle branch block can throw off the timing of the heart's contraction. This can make the heart's squeezing contraction even weaker.
A biventricular pacemaker and ICD help keep the heart pumping in a more normal way. The pacemaker device keeps the heart from beating too slowly. It tries to restore the normal squeezing pattern of the heart.
This is called resynchronization pacing. This can lead to more efficient and stronger heart contraction. The ICD part of the device detects dangerously fast heart rhythms and stops them. If the device detects an abnormally fast heartbeat that can cause cardiac arrest, it will send a "shock" to the heart. The shock stops this dangerous heart rhythm and restores a normal heartbeat. Follow instructions from your doctor about bathing the night before and the morning of your procedure.
You may need to use a special cleaning solution. You will need to arrange to have an adult drive you home the day you are discharged. The success rate for implanting an ICD is quite high greater than 99 percent. However, when implanting a 3-lead ICD system, placement of the third lead may not be successful in about percent of patients. This third lead is only required for pacing. The delivery of ICD shocks is still available. The risk of complications with an ICD implantation is low approximately Possible complications include injury to blood vessels, the heart wall or lung tissues, stroke, breathing complications, an infection that would require device removal and death.
There is also the chance that your ICD device could have a random component failure. If this happens, the ICD or lead may need to be replaced. Your ICD will need to be periodically evaluated. At these evaluations, the health of your ICD will be checked including the leads and the battery function. ICDs can also store information about your heart rhythm. This information will be reviewed as well. Some ICDs can be evaluated with a home monitoring system.
This system uses a unique monitor that sends the ICD information over the Internet. This information can then be reviewed by our staff at the Device Clinic. All information sent over the Internet is only reviewed during normal business hours. Home monitoring can not change or reprogram the ICD parameters but more information about the leads and heart rhythm can be obtained from the system. Home monitoring does not treat any medical condition. There is no interaction between a microwave and an ICD.
The likelihood of adverse interactions when using your cell phone is quite low. However, we do recommend talking on the opposite side from your defibrillator when using your cell phone. When going through airport security, it is important to notify the security personnel that you have an ICD. They may ask you to show them the defibrillator card and we recommend that you ask to be hand-searched.
An ICD may be sensitive to anti-theft systems often found in stores and public libraries. These systems will not adversely affect the ICD if you walk through them in a normal manner without lingering. Arc welding or other devices that can emit electronic magnetic signals can interfere with defibrillators.
If you have hobbies or your work involves interaction with devices that can emit large magnetic fields or electromagnetic interference, it is best that you discuss this with your physician before returning to work. Transplantation Evaluation.
Valvular Surgery. When the heart rate drops below the rate set with the pacemaker, it senses the drop and transmits electrical impulses to the left as well as the right ventricle to contract simultaneously, improving the ejection fraction and the cardiac function.
The lead placed in the right atrium helps the heart to function in a more balanced way. Biventricular pacemaker implantation is also called cardiac synchronization therapy and is only a part of any comprehensive heart failure management program. Medications, life style changes and regular follow up with a cardiac specialist are all crucial for managing the symptoms and improving the quality of life in heart failure patients. The device is usually implanted using the transvenous approach.
In this approach, a small incision is made in the chest of the patient after numbing the area with local anesthetic. Sedation is also given. The lead is then inserted through this incision into a major vein to reach the specific chamber of the heart. This is done under the guidance of real-time X-ray images provided by fluoroscopy.
Two of the leads are guided to the right atrium and right ventricle. The third lead is guided to the left ventricle through the coronary sinus. The ends of the leads are then attached to the heart muscle. After one end of the lead is attached to the heart muscle, the leads are checked for proper placement and functioning through a lead function test called pacing.
Once the leads have cleared the test, the other end of the lead is then connected to the device, which is usually placed in a pocket under the skin in the upper chest and the incision is closed. The whole implantation procedure usually takes around 2 to 4 hours. The recovery is fast in the transvenous approach and the patient is discharged from the hospital in about 24 hours.
In rare cases, when the transvenous approach cannot be used, the device is implanted in the pocket underneath the skin in the lower abdomen epicardial approach. An ICD can also be programmed to work as a basic pacemaker as needed. Sometimes after a shock is delivered, the heart may beat too slowly.
The ICD has a "back-up" pacemaker, which can stimulate the heart to beat faster until the normal heart rhythm returns. The ICD can act as a pacemaker any time the heart rate drops below a preset rate. It allows for the delivery of high-energy shocks while avoiding the potential risks and complications associated with leads that traverse the veins leading to the heart. You may need an ICD if you have survived sudden cardiac arrest due to ventricular fibrillation, or have fainted due to ventricular arrhythmia, or if you have certain inherited heart conditions.
An ICD is generally needed for those at high risk of cardiac arrest due to a ventricular arrhythmia. This includes people with heart failure who have problems with the contraction of the heart, such as abnormal left ventricular ejection fraction. If you are pregnant or think that you could be, or are currently breastfeeding, tell your healthcare provider.
Lying still on the procedure table for the length of the procedure may cause some discomfort or pain. There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your healthcare provider before the procedure. You will be asked to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if something is not clear.
Tell your doctor if you are sensitive to or are allergic to any medicines, iodine, latex, tape, or anesthetic agents local and general. You will need to fast for a certain period before the procedure. Your doctor will tell you how long to fast, usually overnight. Tell your doctor of all medicines prescription and over-the-counter and herbal or other supplements that you are taking.
Tell your doctor if you have heart valve disease, as you may need to take an antibiotic before the procedure. Tell your doctor if you have a history of bleeding disorders or if you are taking any blood-thinning medicines anticoagulants , aspirin, or other medicine that affect blood clotting. You may be told to stop some of these medicines before the procedure. Your doctor may request a blood test before the procedure to see how long it takes your blood to clot.
Other blood tests and chest X-ray may be done as well. Having an ICD implanted may be done on an outpatient basis or as part of your stay in a hospital. You will be asked to remove any jewelry or other objects that may interfere with the procedure.
An intravenous IV line will be started in your hand or arm for injection of medicine and fluids, if needed. You will be connected to an electrocardiogram ECG monitor that records the electrical activity of the heart during the procedure using. Your vital signs heart rate, blood pressure, breathing rate, and oxygenation level will be monitored during the procedure. You will receive a sedative in your IV before the procedure to help you relax. However, you will likely remain awake during the procedure.
Once the anesthetic has taken effect, the doctor will make a small incision at the insertion site. A sheath, or introducer, is inserted into a blood vessel, usually under the collarbone. The sheath is a plastic tube through which the ICD lead wire will be inserted into the blood vessel and advanced into the heart. It will be very important for you to remain still during the procedure so that the catheter does not move out of place and to prevent damage to the insertion site.
The lead wire will be inserted through the introducer into the blood vessel. The doctor will advance the lead wire through the blood vessel into the heart. Once the lead wire is inside the heart, it will be tested to verify proper location and that it works.
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