Perfect so I think in the past, those of you may want to refer back we’ve already done some Facebook lives on pacemakers. So keeping the curriculum on we have moved on to discuss what is an ICD And A CRTD. So as the name implies, ICD is how it looks, if you may see. And what is this is a little device like a matchbox. As you can see. This is an implantable cardioverter-defibrillator and that’s what an ICD is. You would have seen in movies that when there is something an untoward rhythm happening or when the patient is being the life is being lost, you would have seen that they suddenly bring in a big defibrillator and put the pads on the patient’s chest and give an electrical shock. Now imagine all of that has been encapsulated into a small device such as this, this is an ICD. It is like a very intelligent Best Cardiologist Doctor In Janakpuri sitting inside your chest wall. It is as if an emergency room is inside your chest wall. This is typically implanted on the left side under your collarbone and this ICD communicates with the heart with the help of a lead. Now, this is what a leader looks like. So this is how we lead looks like this is a lead, the lead goes into the device and this lead through our venous system enters our heart. So the heart is the time in communication with this ICD with the help of this lead. ICD is a medical marvel. It has been around for the past say about three to four decades. So this is what an ICD looks like. And this is what a CRT D looks like. So CRT D is also very similar in its size, shape appearance. Although it has technicalities far more encapsulated inside it than an ICD And A CRTD. You have to also remember that this ICD is a unique device, it has the ability to give a shock to give therapy as much as 600 volts. You should remember the electric current that we get in our homes is 220 words, imagine a device as compact as this can deliver as much therapy and it has to give as much therapy to revive our rhythm. So that we are alive again if we are going to succumb to death.
Thank you. So, you have beautifully explained how this device is implanted. So, I would like to ask, how much time does it take to implant these devices.
So these devices as I told you are technically challenging. If a device is needed, an ICD typically takes about one hour. ICD And A CRTD can take anywhere from one to two hours because it depends upon the individual’s anatomy, it depends upon the operator’s experience. All of this coupled together with the CRT D certainly takes longer than an ICD.
Read Also:- How Do I Take Care Of A Pacemaker?
How Long Can Someone Live With A Crt?
That’s a fantastic question because we must understand that these devices are battery-operated devices, these battery-operated devices. So within this little device is a capacitor that increases the current and gives as much as 600 volts and there is a small battery. These are very special batteries being As ICD or be the CRT these devices have batteries that can last anywhere between seven to nine years. However, we must understand people have this myth that they can be recharged from outside or they can live forever, which is not true. They have batteries and capsulated and the typical life is anywhere from six to nine years.
Right Man Thank you. You have explained the difference between ICD and CR dt I would like to ask like is SATA is ERP better than ICD or are they the same?
So, the question is, if this is an ICD and this is a CRT D, what is better? It’s not what is better it is what does a patient need? Individuals who have poor pumping of the heart are at Risk of Sudden Cardiac Death. If you are at risk of sudden death, the device that you need is an ICD with how do we know that your pumping is poor by doing an echocardiogram on an echocardiogram, if your heart pumping comes out to be poor means less than E f is less than 35% It implies that you will benefit from a device which is called ICD if you have pumping, which is less than 35% and you have symptoms of breathlessness, and you have a specific defect on your ECG, which is called a left bundle branch block, then we say that our patients should be implanted is CR TD. So, there are two distinct devices each very good, not competing with each other, but complementing each other depending upon what is required for an individual patient.
Right. So My Question Is Associated With This Only, Like Can Icd And Crtd Improve Ejection Fraction.
Whenever we implant these devices, be it an ICD or be it a CRT D. The agenda in a doctor’s head is to make the patient live better, live longer. Individuals who have poor pumping of the heart. If given a defibrillator, we increase their life. Individuals who have word pumping of the heart and have Symptoms of Heart Failure and have a specific effect on the ECG. We give them a CRT with the impact that it will make them live longer and also improve their quality of life. So when we give an ICD we tell our patients very clearly that an ICD is not to improve your ejection fraction and ICD is to protect you from sudden cardiac death. But when we give ICD And A CRTD, we tell our patients that this device will not only protect them from sudden cardiac death because it has an embedded ICD in it, but it will also improve the pumping of the heart. But you must remember each of these devices is given to a special subset of patients and each must qualify for the given device.
We Have Heard About The Crt Pacemakers. So Can You Please Enlighten Us On This?
Yes. So, there is we just understood there is an ICD, we understood there is a CRT D is a device which has an ICD incorporated it also it has a special thing called CRT cardiac resynchronization therapy. So sometimes because of certain financial constraints or other issues such as the patient being very elderly patient being having too many comorbidities, or patient’s skin is very thin, or the patient unable to afford a CRT D sometimes we offer our patients what is called a CRT P. CRTD is a cardiac resynchronization therapy pacemaker where it does not have a defibrillator implanted within it. It is offered to patients who have poor pumping of the heart and associated have a left bundle branch block on the ECG and have symptomatic heart failure. The CRT p is a very good device, it is a much more compact device than an ICD And A CRTD. Again, each of these devices is not competing with each other but they are complementing each other. And each of these devices is to be given to an individual patient after your doctor decides what is best for your patient.
what should someone do when he or she receives a shock from an ICD? And how painful is this shock?
I think that’s something when we as electrophysiologists or cardiologists whenever we offer For our patients, these devices, we implant these devices, we generally give them a leaf or we give them an education note why? The reason is, these devices are a medical marvel. However, at times, they become troublesome for the patient, especially if a patient receives a shock, we must understand that if we are going to die, this device has been taught by us to give maximum energy shock, so that we are revived. Some of you would have watched the recent Eurogames which happened and the captain of the Denmark team had a sudden cardiac death on the field. So suddenly, there was a team which ran up there and gave him a shock. Now they gave a shock with maximum energy because that was the only way you could revive an individual, you have to give maximum energy. Unfortunately, sometimes you may receive a shock when you’re awake. If you receive a shock, if an individual has an ICD And A CRTD, and he receives he or she receives a shock, when they are awake, it can be painful. So we tell our patients we educate them, that you may receive a shock. If you receive a single shock, you must not panic. If you panic and are in a rush and hurry, the device can sometimes give more shocks because you will have high heart rates. So we always tell our patients if they receive a single shock, don’t panic just be rested. However, if you receive three or more shocks in succession, or within an hour, within 24 hours, we always tell our patients to come to a hospital, you will need device interrogation, it is done externally, you will need your electrolytes to be checked, which is essential. You may need some medications to terminate your rhythms. So if you receive more than one shock, it’s a good idea to go back to your Doctor’s Best Cardiologist in Delhi. If you receive a single shock be rested, you can visit the clinic in a day or two.
How Many Times Someone Can Receive A Shock With A Defibrillator? Is It Fixed Or Not?
Yeah, rise. So the defibrillator has been taught that when it sees an abnormal rhythm, it will try its best to bring the patient back, I told you that these are medical marvels, this is our friend, this is a device which when indicated given to the right person makes the patient actually live longer. However, all of us are this time to die, it will not make us live forever. So what does it do? Whenever it sees an abnormal rhythm, it understands that I have to work it will give a shock. When this gives a shock, it can give as many as six shocks in succession. And then it will stop for a while. It may see the rhythm again in some time. And again, give six sharps, six shocks to these programmable numbers that we have. But typically, this device will do its best to revive the life, and more often than not, it works very well the success of termination of abnormal rhythm is very high and very good.If you are suffering any type of heart discomfort so Book an Appointment with Dr. Aparna Jaswal Top Heart Specialist Doctor in India…#fortis
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