Overview of AICD Implantation in India

An Automatic Implantable Cardioverter Defibrillator (AICD) is an electronic device that is used to treat heart conditions where heartbeats are arrhythmical or in abnormal way. These devices are implanted into the chest of the patient who is suffering from the deadly disease of arrhythmia. AICD either limits the abnormal rhythm of the heart by a burst of pacing or sends signals to the heart in the form of an electric current to reset the abnormal rhythm of the heart.

AICD Implantation Cost in India

The cost of AICD Implantation in India ranges from 8000 USD to 15,000 USD. The cost can vary according to the type of procedure being performed in the surgery. The cost can also vary according to the skill of surgeons and if any complication occurs during surgery. 

  • AICD: 8,000 USD to 15,000 USD
  • Single-Chamber AICD: 8000 to 9000 USD 
  • Dual-Chamber AICD: 10000 to 12000 USD
  • CRT-D Implant: 9,000 USD to 11,000 USD
  • Implantable Cardioverter Pacemaker (ICP): 12,000 to 15,000 USD

City-Wise Variations of AICD Implantation Cost in India

  • Mumbai: 9000 to 12000 USD
  • Delhi: 8000 to 11000 USD
  • Chennai: 8000 to 10,000 USD
  • Bangalore: 8000 to 10,500 USD

Types of Aicd Implantation Treatment India

Some of the AICD that are used in surgical procedures are as follows:

  • Single-Chamber AICD
  • Dual-Chamber AICD
  • Biventricular AICD (CRT-D)
  • Subcutaneous ICD (S-ICD)
  • MRI-Compatible ICD
  • Leadless ICD
  • Implantable Cardioverter Pacemaker (ICP)

Single-Chamber AICD

This type of ACID has one lead connected to either the upper or lower part of the right side of the heart. It monitors the rhythm of the heart and sends signals in the form of electric shocks after the detection of abnormal rhythm in that chamber.

Dual-Chamber AICD

In a dual-chamber AICD, two leads are placed in both the right upper and the right lower part of the heart. This allows the device to monitor and correct abnormalities in both chambers. It provides more functional and targeted treatment.

Biventricular AICD

Biventricular AICD is also known as Cardiac Resynchronization Therapy (CRTD). This type of AICD is used for patients with heart failure and with dangerously abnormal rhythm of the heart. It has leads in the right upper part of the heart, the right lower part of the heart, and another in the left lower part of the heart. CRT-D devices can help with the normal rhythm of the heart and improve the overall function of the heart.

Subcutaneous ICD (S-ICD)

This type of AICD has no leads inside the veins or heart. S-ICDs have leads placed just under the skin along the rib cage. This type of AICD is suitable for individuals who cannot have leads inside their veins or hearts or for those with a higher risk of infection.

MRI-Compatible AICD

Some AICDs are specifically designed to be safe for use in magnetic resonance imaging (MRI) tests. These devices are used to minimize the interactions between the device and the MRI machine. Patients with MRI-Compatible AICD can have an MRI test.

Leadless AICD

Leadless AICDs are devices that do not require leads to be placed inside the heart. Instead, they are implanted directly within the heart's chamber and can treat the abnormal rhythm of the heart.

Implantable Cardioverter Pacemaker (ICP)

Some devices combine the features of both an AICD and a pacemaker. These devices can provide pacing therapy for slow heart rhythms and also deliver shocks to treat life-threatening abnormal rhythms of the heart.

Procedure of AICD Implantation

Here is a general overview of the procedure of AICD implantation:

Anesthesia: The anesthesia is given to the patient before the procedure to minimize the effect of pain and discomfort.
Incision: A small incision is made under the collarbone on either the right or left side of the chest. The surgeon creates a pocket under the skin and muscle tissue for the accommodation of the AICD device.
Lead Placement: Thin, insulated wires are inserted through a vein and guided to the heart. These leads can sense the electrical activity of the heart and deliver shocks when needed. The leads are attached to specific areas of the heart, usually the right lower and upper side of the heart.
Device Implantation: The AICD device is placed in the pocket. The device contains a battery, a microcomputer, and circuitry to monitor the rhythm of the heart and deliver shocks when necessary.
Lead Connections: The leads are connected to the AICD device, and their placement is checked by using X-ray pictures.
Incision Closure: After successful placement of AICD, the leads are secured in place and the incision is closed by using sutures. Bandage dressings are applied to the wound.
Recovery: The medications are used for the prevention of infection and the formation of blood clots in the recovery phase. A gradual increase in physical activity is recommended.

Cost Comparison Between India and Different Countries

The cost of AICD implantation is very much affordable in India as compared to other Western countries. The comparison is shown below

  countries

  starting price in USD 

  India

  8000 USD

  UK

  23,000 USD

  USA

  25,000 USD

  Thailand

  17,000 USD

  UAE

  15,000 USD

Symptoms and Risk factors

Some of the indications of AICD Implantation are as follows:

  • Ventricular Tachycardia (VT) or Ventricular Fibrillation (VF)
  • Sudden Cardiac failure 
  • Ischemic Cardiomyopathy
  • Non-Ischemic Dilated Cardiomyopathy
  • Hypertrophic Cardiomyopathy
  • Long QT Syndrome
  • Brugada Syndrome
  • Arrhythmogenic Right Ventricular Dysplasia (ARVD)
  • Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT)
  • Certain Inherited Arrhythmia Syndromes
  • Certain Congenital Heart Diseases
  • Heart Failure with Reduced Ejection Fraction and High Risk of Sudden Death
  • Secondary Prevention in Patients with Significant Heart Disease

Risk factors of AICD Implantation

Some of the risks that are associated with AICD implantation are:

Infection

Like any surgical procedure, there is a risk of infection at the site of implantation. This can include infection of the incision site or anywhere in the body.

Bleeding and Hematoma

Bleeding at the surgical site or the collection of blood can occur after the procedure. This complication can further affect the recovery.

Allergic Reaction

Some patients might experience an allergic reaction to the materials used in the device or the sutures.

Blood Vessel or Heart Damage

There is a small risk of damaging blood vessels or the heart during the implantation of AICD. The damage can lead to severe complications and even death.

Lead Displacement

The leads that connect the AICD to the heart can become displaced, which may affect the ability of the AICD to function properly.

Device Malfunction

AICDs are electronic devices and although it is rare, sometimes the device may be damaged. This might include failure to deliver treatment when needed or delivering treatment when not needed.

Inappropriate Shocks

AICDs are designed to deliver shocks when they detect a dangerous arrhythmia. However, there is a possibility of the device delivering inappropriate shocks due to misinterpretation of heart rhythms.

Fluid Accumulation

Fluid can accumulate around the device or lead that can cause discomfort or disturb the function of the device.

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