Upon discharge from the hospital, you will receive a temporary certificate, which is filled in by your doctor and identifies you as a patient with an implanted ICD. The card contains important information about the implanted device, as well as your doctor’s phone number in case of questions or medical needs.
There is a special form in the box with your implantable device, which must be filled in by your doctor. A few days after discharge from the hospital, you need to call Sorin and based on your ICD documents and your passport data, a permanent plastic card from Sorin will be issued.
You will need a patient card in case of emergency medical cases, passing the safety framework at airports and during scheduled consultations.
If you changed your doctor, moved or received a new phone number, please contact your implant doctor.
An example of a patient identification card with an implanted ICD device.
On your ID card:
• The model and serial numbers of your device.
• Your name, address and phone number.
• Date of implantation of the device.
• Name, address and telephone number of the doctor who performed the implantation.
Your doctor will advise you on how to avoid situations in which short-term dizziness or loss of consciousness can lead to tragic consequences for you and others.
• Steering a boat alone.
• Climbing stairs.
Patient admission to driving is regulated by law. To drive a vehicle, you will need to go through the Medical Driving Commission (MVC). Your doctor can give his opinion for consideration at the MVK, where your current state of health and what kind of drug therapy will be reflected. As a rule, patients return to driving after complete healing of the postoperative wound, if in the anamnesis, prior to ICD, VT attacks were not accompanied by loss of consciousness.
Be sure to tell your doctor about all episodes of dizziness or loss of consciousness.
Always follow medical advice to return to normal physical activity. Your doctor will agree with you what workload you can perform during the day in order to gradually return to a full life.
• Return to work.
• Resumption of sexual activity.
• Travel and sports.
Return to work
An implantable cardioverter-defibrillator (ICD) should not interfere with your work, except in special circumstances. Since each workplace differs in the type and orientation of work, there are no single recommendations.
You will need to tell your doctor if your work is related to the following devices:
• High voltage electrical equipment.
• Strong magnets used in industrial areas.
• Radar, or other sources of strong electromagnetic interference.
At work, you need to inform employees that you have an ICD implanted and to warn you what measures to take during ventricular tachycardia and defibrillator discharge.
Most of the various instruments, equipment and devices surrounding us at home or in the workplace do not affect the operation of the pacemaker and can be used with minimal or no precaution. Modern pacemakers are quite well protected from external magnetic, electrical and electromagnetic influences found in everyday life. However, some devices containing electrical and magnetic components can affect the function of the pacemaker.
Around the devices and objects containing electrical and / or magnetic components, an electromagnetic field is formed. A strong electromagnetic field can interfere with the normal operation of the pacemaker, which leads to inadequate - insufficient or excessive - stimulation of the heart.
If you experience dizziness, rapid or irregular heartbeat caused by external exposure to a pacemaker of any equipment, just quickly move away from it to a safe distance. Your pacemaker will resume normal operation immediately.
ICD does not limit sexual activity. There are precautions that must be observed and be sure to consult a doctor to obtain specific information about ICD settings. During sexual intercourse, the heart rate becomes more frequent and can reach threshold values. Your doctor should analyze and adjust the “detection zone” of your device so that an unreasonable discharge of the defibrillator does not occur.
If you have a defibrillator discharge, then this will not affect the health of your partner and will not harm him.
Your ICD does not limit you in movement, and you can plan your trips for a long period of time. Before planning your trip, you need to consult a doctor and talk about your plans. The doctor will give recommendations on how to behave in various situations and write a dosage regimen.
Take this manual with you in order to familiarize the medical staff with your type of device during your rest, if necessary.
• Consult your doctor and find out which clinics you can go to in case of an emergency. It must be remembered that not all clinics have the ability to program this type of EX and that medical personnel do not always have advanced knowledge of your device.
• Be sure to present your certificate (patient card) at checkpoints at airports, train stations, where screening is carried out using a magnetic frame. It is necessary to show a certificate so that you, if necessary, performed a manual inspection.
The frequency of consultations to check the performance of the ICD is determined by your doctor and is regulated by six months. If you have planned a long trip or business trip, ask your doctor for the addresses of the clinics that have all the sufficient experience and knowledge of your ICD device.
You need to make sure that your insurance company understands that you are a patient with ICD. Many insurance companies may refuse to insure your life, and even more so to pay for your treatment, since, in their opinion, you are at high risk. To resolve many problems you should bring a certificate from a cardiologist about your health condition and that you are allowed to travel.
Be sure to solve all these issues when making out your insurance and do not postpone the solution to this problem later, when an emergency has already occurred.
Exercise, relaxation, travel abroad
Exercise is good for your heart and you will be asked to lead an active lifestyle. You should discuss with your doctor what limitations exist and how to increase physical activity.
Sports and exercise to be avoided:
• Contact sports (such as karate or football).
• Shooting from a gun or rifle. You can not put the butt of the gun in the shoulder area where the ICD is implanted. Kickback can cause surface tissue injury above your ICD.
ATTENTION : Avoid exercises and activities that threaten to hit your skin over the ICD. A blow, as a rule, cannot harm your device, but it can damage the tissues above the ICD.
Avoid direct exposure to sunlight on the implanted ICD area. Be sure to wear at least a T-shirt or other clothing to shield this area.
In what situations is it necessary to call a doctor
Your doctor will give clear instructions on when to call him. Some examples if you have:
• A defibrillator discharge or any other therapy for your ICD has occurred.
• You feel a rapid heartbeat for 3 minutes or longer.
• The ICD beeps.
• Signs of inflammation in the area of ICD implantation (hyperemia, redness, swelling, fever or discharge from the suture occurred in the suture area).
• Fever for 2 to 3 days.
• You have questions about ICD or the medications you are taking.
• You are going on a trip or a business trip for the long term.
• There are new unexplained symptoms, or the symptoms you experienced before the operation resumed.
Most patients with ICD describe their feelings this way:
• Antitachycardia stimulation: impulses are not felt or they are painless.
• Defibrillation: if the patient loses consciousness at the time of fibrillation, the ICD discharge is not felt. If the patient is conscious, then when the ICD is discharged, a sensation of a rather strong “blow” occurs, but it is short-lived.
The sensations of each patient are individual and may differ from those described.
In case of life-threatening ventricular tachycardia, the ICD defibrillates with a high-power pulse that restores the normal heart rhythm.
If you have a feeling of a heartbeat, then it is more likely that your ICD will work to suppress the pathological rhythm by a defibrillator discharge.
Your doctor will discuss with you and give specific instructions on what to do in case of a threat of defibrillator response.
These may include the following rules:
1. Keep calm. Find a seat for yourself, and if possible, lie down.
2. If possible, ask someone around you to stay with you during the threat. During the operation of the ICD defibrillator, bodily contact of a person with you is allowed. He may experience a slight tingling sensation without harming his health.
A discharge occurs inside the heart between the electrode poles. During an attack, you may lose consciousness, and when the ICD is triggered, you will contract muscle groups with a visual bouncing effect (severe shuddering).
3. Your relatives or colleagues must have a telephone number for the ambulance and your doctor. They must call the ambulance if you remain unconscious for more than a minute.
4. If you woke up or remain conscious after the ICD is triggered, but you feel unwell, ask your doctor urgently to call. Follow all the doctor's recommendations and if necessary, call the ambulance service.
5. If, after triggering the ICD, you feel relatively good with a gradual recovery of well-being, then for you and others there is no urgent need to call an ambulance. Call your doctor and follow all his recommendations. Your doctor may ask you to answer the following questions:
• What did you do just before defibrillator discharge?
• What are your feelings and symptoms before shock therapy?
• How did you feel after the shock therapy?
In order to avoid many complications, you need to plan the options for providing first aid with your family, friends or colleagues and, if possible, immediately call emergency medical personnel.
At the end of this manual, in the "user information" section, there is a place for recording all the information, which indicates the numbers of your doctor, ambulance and information about the therapy.
Be sure to make a copy of this information and place it in a prominent place near the phone in case of emergency.
New generation defibrillator implanted under the skin will help to survive
In the USA, a subcutaneous defibrillator has been developed, which has almost one hundred percent effectiveness. This easy-to-install device can make life easier for patients with heart disease.
Defibrillator - a medical device used for electropulse therapy of heart rhythm disturbances. Implantable defibrillators have been used for the fourth decade.
The head physician of the Penza Cardiocenter about the future of cardiology and heart diseases
Their use significantly reduced mortality from sudden cardiac arrest caused by ventricular tachycardia or ventricular fibrillation: within a few seconds after the onset, the attack is relieved by electrical discharge.
However, the use of such devices is associated with a number of risks. Since the electrodes are implanted directly in the blood vessels located near the heart, there is a danger of infection entering there. An undesirable consequence is also damage to the vessel itself. Moreover, the patient, as a rule, lives longer than the life of the defibrillator, and in this case, an operation to replace it is necessary.
In the magazine Circulationprint organ American Heart Association, an article appeared with a detailed description of the clinical trials of the subcutaneous S-ICD defibrillator. Late last year, based on these tests, the Food and Drug Administration (FDA) approved the use of this revolutionary device in the United States.
The ancient Egyptians also suffered from atherosclerosis
The S-ICD system, developed by Cameron Health, a company that manufactures medical equipment, is the world's first defibrillator that is implanted near the sternum under the skin. This allows you to avoid various complications caused by the need for intravascular manipulations and the presence of foreign objects in the veins. The advantage of S-ICD is its ease of installation, due to the subcutaneous location of all components of the defibrillator.
The device is a disk with a diameter of not more than 4 cm, it has only one wire coming from the external battery-powered control unit. The fact that the electrodes and sensors are located under the skin, and not inside the blood vessels, allows the device to generate a discharge of 2.5 times greater force.
Without replacement, the defibrillator can work for five years.
True, it costs not cheaply - about $ 20 thousand, which so far holds back its wide distribution.
Unmarried people more likely to die after a heart attack
Clinical trials of the defibrillator, in which 330 patients took part, were conducted over 11 months in 33 different US clinics, with most patients at home. During this time, 21 people had 38 heart attacks, each of which was safely prevented. In 41 patients, unexpected attacks were prevented, which were not preceded by dangerous heart failure. During the test, eight observed died, but at least seven deaths were not associated with heart disease or a defibrillator failure, and one person died at home alone. Not a single defibrillator failed, nor was a shift in the subcutaneous devices or electrodes noted.
The effectiveness of the defibrillators as a result of the tests was evaluated by an indicator close to 100%, while the “passport” efficiency, that is, what physicians sought at the request of the FDA, does not exceed 80%.
According to the professor Martin burke of University of Chicago, who led the tests, the effectiveness of the new device is due to the fact that during the twelve-year development, it has incorporated the best qualities of traditional external and implantable defibrillators.
However, subcutaneous defibrillators are not indicated for all patients. So, they are not suitable for patients with symptoms associated with a slow heartbeat. Professor Burke comments on this: “S-ICD does not replace other defibrillators, but complements them. It is ideal for some patients, but not for others. Henceforth
patients themselves can choose what is best for them. ”