An Automatic Implantable Cardioverter Defibrillator (AICD) is an electronic device that is used to treat heart conditions where heartbeats are arrhythmical or an abnormal way. These devices are implanted into the chest of the patient who is suffering from the deadly disease of arrhythmia. AICD implantation is one of the most effective ways to treat the abnormal rhythm of the heart. This device works in two ways: in one way the AICD limits the abnormal rhythm of the heart by a burst of pacing and in the other way, the device AICD sends signals to the heart in the form of an electric current to reset the abnormal rhythm of the heart. Automatic Implantable Cardioverter Defibrillator device also stores information about the abnormal activity of the heart which is useful for doctors to understand the nature of the disease. AICD consists of a generator, which creates impulses, a lead, that connects the pulse generator to the heart, electrodes that are in direct contact with the heart, and a microcomputer that detects the abnormal activity of the heart. Although AICD Implantation is usually a safe procedure, it still carries some risks along with it. These risks should be minimized to prevent complications by taking precautions in advance. The Automatic Implantable Cardioverter Defibrillator has been used by healthcare professionals for treating life-threatening situations for patients and improving their life quality.
Some of the AICD that are used in surgical procedures are as follows:
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.
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 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.
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.
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 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.
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.
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.
The cost of AICD Implantation in India ranges from 7000 USD to 12,000 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.
Treatment Costs in India | Min in USD | Max in USD |
AICD | 7459 USD | 9945 USD |
CRTD-Implant | 9057 USD | 12076 USD |
Some of the indications of AICD Implantation are as follows:
Some of the risks that are associated with AICD implantation are:
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 at the surgical site or the collection of blood can occur after the procedure. This complication can further affect the recovery.
Some patients might experience an allergic reaction to the materials used in the device or the sutures.
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.
The leads that connect the AICD to the heart can become displaced, which may affect the ability of the AICD to function properly.
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.
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 can accumulate around the device or lead that can cause discomfort or disturb the function of the device.
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