AICD Implantation

Who Needs AICD Implantation

An Automatic Implantable Cardioverter Defibrillator (AICD) is recommended for individuals at high risk of life-threatening cardiac arrhythmias. These include:

1. Patients with a History of Sudden Cardiac Arrest: Those who have survived a sudden cardiac arrest due to ventricular fibrillation or ventricular tachycardia.
2. Patients with Severe Heart Disease: Individuals with a significantly weakened heart muscle (heart failure or cardiomyopathy) who are at increased risk for sudden cardiac death.
3. Patients with Genetic Conditions: Those with inherited conditions such as Long QT Syndrome, Brugada Syndrome, or hypertrophic cardiomyopathy, which predispose them to dangerous arrhythmias.
4. Patients with Prior Myocardial Infarction: Individuals who have experienced a heart attack and have reduced heart function (ejection fraction less than 35%)

When to See a Specialist

You should consult a cardiologist, especially an electrophysiologist (a heart rhythm specialist)

Procedure

1. Preparation: You may need to fast for several hours before the procedure, and medications might be adjusted.
2. Anesthesia: The procedure is usually performed under local anesthesia with sedation, but general anesthesia may be used in some cases.
3. Incision and Lead Placement: A small incision is made near the collarbone. Leads (wires) are inserted through a vein and guided to the heart, where they are attached to the heart muscle.
4. Device Placement: The AICD device, which is about the size of a pocket watch, is placed under the skin in the upper chest and connected to the leads.
5. Testing: The device is tested to ensure it can correctly detect and treat arrhythmias. The incision is then closed with sutures.

Recovery

1. Hospital Stay: Most patients stay in the hospital for 1-2 days for monitoring.
2. Activity: Strenuous activity and heavy lifting should be avoided for several weeks. Normal daily activities can usually be resumed within a few days.
3. Wound Care: Keep the incision site clean and dry. Follow your doctor’s instructions for wound care.
4. Follow-Up: Regular follow-up appointments are essential to monitor the device’s function and adjust settings if necessary.

Risks

While AICD implantation is generally safe, there are potential risks, including:

• Infection at the site of the incision.
• Bleeding or bruising.
• Damage to blood vessels or the heart from the leads.
• Lead displacement.
  Allergic reactions to anesthesia or contrast dye used during the procedure.
• Device malfunction or inappropriate shocks.

Benefits of AICD Implantation

1. Prevention of Sudden Cardiac Death: The primary benefit is the prevention of sudden cardiac death due to life-threatening arrhythmias.
2. Automatic Detection and Treatment: The device continuously monitors heart rhythm and delivers shocks or pacing to restore normal rhythm if an arrhythmia occurs.
3. Peace of Mind: Knowing that you have protection against sudden cardiac death can improve quality of life.
4. Improved Survival Rates: For those at high risk, an AICD significantly improves survival rates compared to medication alone.

Frequently Asked Questions

1. How long does the procedure take?

The procedure typically takes between 1 to 3 hours.

2. Is the procedure painful?

You may experience discomfort during the procedure and mild pain at the incision site afterward. Pain is usually well-managed with medications.

3. How long does the AICD last?

The battery of the device typically lasts 5 to 7 years, after which the device needs to be replaced.

4. Can I resume normal activities after implantation?

Yes, but you should avoid strenuous activities and heavy lifting for several weeks. Your doctor will provide specific guidelines based on your condition.

5. Will I feel the shocks?

If the device delivers a shock, it may feel like a sudden jolt or thump in the chest. Some people describe it as uncomfortable but not necessarily painful.