Implantable Cardioverter Defibrillators (ICD) Surgery in India

Overview

An Implantable Cardioverter Defibrillator (I.C.D.) consists of a small box containing a computer and battery. It is the size and weight of a pack of playing cards. It can be implanted into the body where it is capable of observing heart rhythm continuously. The device is connected to leads, positioned inside the heart or on its surface. These leads are used to deliver electrical shocks, sense the cardiac rhythm, and pace the heart, as required. The various leads are tunnelled to a pulse generator, which is implanted in a pouch beneath the skin of the chest or abdomen (epicardial). These generators are typically a little larger than a wallet and have electronics that automatically monitor and treat heart rhythms recognized as abnormal. When an implantable cardioverter defibrillator detects ventricular tachycardia or fibrillation, it shocks the heart to restore the normal rhythm. ICD .delivers electric shocks to the heart in order to correct an excessively fast or erratic heart rate or rhythm. It will not prevent such a rhythm from happening, but will correct it and so save your life. The ICD is programmed to deliver a shock if the heart rate exceeds a particular figure for more than a given time. When your heart rhythm becomes erratic you may faint and wake up when the defibrillator has given a shock.

Disorders Treated with Implantable Cardioverter Defibrillators (ICD)

This electronic device is designed to monitor a patient’s heart rate, to recognize ventricular fibrillation (VF) or ventricular tachycardia (VT), and to deliver a shock to terminate these life-threatening arrhythmias for patients who are at risk. It can be programmed to treat an abnormal rhythm which could endanger a person’s life. These disturbances in the heart rhythm occur in the lower chambers of the heart and are referred to as Ventricular Tachycardia [VT] and Ventricular Fibrillation [VF].

• Ventricular Tachycardia - This is a life threatening problem with the rhythm of the heart where the ventricles beat very quickly. This interferes with the pumping of the blood around the body which can cause dizziness, loss of consciousness and sudden cardiac arrest.
• Ventricular Fibrillation - This is similar to ventricular tachycardia only the heart beats even faster and more erratically, over 300 beats each minute, and the electrical action is quite disorganized. Very little blood is pumped from the heart and around the body. A person with ventricular fibrillation becomes unconscious very quickly.

Preparations for Implantable Cardioverter Defibrillators Surgery

• Do not eat or drink anything for at least six hours before the ICD procedure.
• Discuss your medications with your physician beforehand and follow his or her advice on whether you should stop taking them for a few days before the ICD procedure.
• Refrain from using aspirin or blood thinning medications for a few days as well. You may take approved medications with small sips of water.

Implantable Cardioverter Defibrillators (ICD) Surgery Procedure

The implantation of the ICD is a simple procedure. The procedure takes about two hours. The patient is given a sedative injection. Local anaesthetic will be injected into an area on the left side of your chest just below your collar bone. A small incision is made and a small tube is inserted into a large vein. Through this tube a wire is passed into the lower chamber on the right side of your heart [your right ventricle]. Occasionally two wires are required; the second wire in such cases is passed into the upper chamber on the right side of the heart [your right atrium]. The wire is then tested and attached to the ICD box which contains the batteries and computer. A small pocket will be formed under the muscle and the box will be carefully positioned in the pocket. Before the procedure is completed the surgeon would take certain tests to confirm that the ICD is working properly. When the tests are completed your doctor would close the wound using a few stitches and a small dressing would then be applied. The stitches will dissolve automatically. The patient may expect to stay in the hospital for 2 nights after the ICD has been implanted.

The next day after the implant the patient may slowly start walking about. Follow-up checks are conducted within the first month of the surgery. These checks are simple and does not cause any discomfort. A communication device [about the same size as the ICD] is placed over the ICD box to make checks and gain information. After this appointment the patient will be asked to return again to Out Patients in 3-6 months.

Follow-Up Care Post Implantable Cardioverter Defibrillators Surgery

• If the wound becomes red or swollen or starts oozing. The patient must keep the wound dry at least for the first week.
• The patient under no circumstance should stop or change any medication without seeking advice from his Cardiologist. If the patient has temperature he should immediately inform the hospital.
• The patient should avoid any heavy lifting, stretching, excessive pushing or pulling. These actions could affect the box and wires in the first few weeks until they are settled in position. Walking and exercise is good for you but it should not be overdone.
• The patient should avoid strong magnetic fields such as those found around some industrial electric motors, security metal detectors and the backs of audio speaker cabinets. Very rarely magnetic fields could switch ICD off. If they do so the patient will hear it bleeping for a short while. If this happens he should get immediate medical.
• Mobile phones must always be at least 15cms (6 inches) away from the ICD.
• As the patient may faint or lose control when the device goes off, he should avoid ladders, non fenced heights, bicycles, swimming, horse riding etc in absence of a companion. The patient should avoid any contact sports which could result in a blow to the implant site.
• The patient should avoid pressure over the place where the device has been implanted, [for example tight clothing, belts or straps of bags or rucksacks.

Benefits of Implantable Cardioverter Defibrillators Surgery

• Implantable cardioverter defibrillators have been very useful in preventing sudden death in patients with known, sustained ventricular tachycardia or fibrillation.
• Studies have shown that patients in the high-risk category for sudden death benefit from having an ICD, regardless of whether they have had any symptoms or any documented abnormal rhythms. ICDs save lives.
• In selected patients with severe obstruction, the ICD acts also as a pacing treatment by producing dyssychrony between the septum and the lateral wall, which lessens the obstruction. This is considered a viable option in patients deemed high risk for surgery or alcohol ablation.
• For primary prevention of sudden cardiac death, ICD implantation in patients with one or more of the previously described high risk markers. In a large cohort, an annual appropriate intervention rate of 3.6% was observed, which amounted to a 17% cumulative rate at 5 years.
• In addition, all current ICDs can be monitored remotely, allowing physicians to get information about possible device malfunctions quickly.

Risks Associated with ICD Surgery

There are few complications associated with ICD cardiac surgery which includes infection – early or late, inappropriate shock, imperfection – device or leads problems, implantation risk – pocket hematoma, pneumothorax, perforation, insufficiency and heart failure – due to tricuspid valve regurgitation, etc.

Implantable Cardioverter Defibrillator (ICD) Surgery in India

Indian hospitals offer the top rated cardiac surgery team in the world. The cardiac surgeons in these hospitals have been performing heart surgery for decades and are widely known for their surgery skills. The cardiac surgeons in India have excellent outcomes for patients suffering from the most critical cardiac disorders. The surgeons perform cutting edge surgical services and leads India in number of complex valve repair and replacement surgeries at the same time pioneer India in minimally invasive techniques, DaVinci robotic-assisted cardiac surgery, implantable cardioverter defibrillator surgery and complex aortic disease treatments. Cardiac surgery in most hospitals in India is performed through cutting - edge clinical solutions, research, extraordinary patient care and infrastructure of world class standards.

Cities in India offering ICD Surgery at some of the best Cardiac Hospital are as follows;

Mrs.Nicola Gould from Australia shares about Implantable Cardioverter Defibrillators Surgery of her father-in-law done in India

Mrs.Nicola Gould and her Father-in-law Mr. Patrick Gould from Australia

My father in law had a heart problem and the doctors suggested us to go for the implantable cardioverter defibrillators surgery to implant a device inside his body that would ensure that his heart is able to perform cardioversion effectively. We did our homework before we connected with the doctors at Indian Health Guru because we wanted to ensure that he gets the best of treatment and when we talked to the doctors at hospital, they made us really feel at ease. They answered all our queries and ensured that we were completely satisfied with how the procedure will be carried out.

Cost of Implantable Cardioverter Defibrillator Surgery in India

Hospitals in India are a perfect destination for medical tourism that combines health treatment with visits to some of the most alluring and awe-inspiring places of the world at an attractively low cost. Clearly, the cost of these devices is high but the medical care costs are high as well especially in developed countries like US, UK, etc. Implantable cardioverter defibrillator for cardiac surgery in India can help most patients save at least upto 60%. The final amount includes hotel accommodation, flights and other travel expenses, medical expenses, hospital fees, etc. Thus, India offers such an expensive and critical surgery at an extremely economical price without compromising on the quality of the service.

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