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Implantable cardioverter-defibrillators

Medical expert of the article

Heart surgeon, thoracic surgeon
, medical expert
Last reviewed: 11.04.2020

Implantable cardioverter-defibrillators perform cardioversion and heart defibrillation in response to VT or VF. Modern ICDF with the emergency therapy function involves the connection of the rhythm driver function in the development of bradycardia and tachycardia (with the aim of stopping sensitive supraventricular or ventricular tachycardia) and recording an intracardial electrocardiogram. Implantable cardioverter-defibrillators are sutured subcutaneously or retrosternally, electrodes are implanted transvenously or (more rarely) during thoracotomy. 

Implantable cardioverter-defibrillators serve as a means of choice for patients who have undergone a VF episode or a hemodynamically significant VT, not associated with reversible or transitory causes (eg, electrolyte imbalance, proarrhythmia due to antiarrhythmic drugs, acute myocardial infarction). Implantable cardioverter-defibrillators can also be shown to patients with VT or VF induced during an electrophysiological study and to patients with idiopathic or ischemic cardiomyopathy, LVEF <35% and high risk of VF or VT. Other indications are less studied. Since implantable cardioverter-defibrillators basically do not prevent but eliminate VT and VF, patients prone to such arrhythmias may need both ICDF and antiarrhythmic drugs to reduce the number of attacks and the need for uncomfortable ICDF discharges; this approach also extends the working life of ICDF.

The drift of generators for ICDF is about 5 years. Implantable cardioverter-defibrillators can fail and, as a result, generate inadequate stimuli or discharges in response to a sinus rhythm or CBT, or do not discharge the appropriate discharge. Variations of ICDF disturbances include migration of electrodes or a generator, inadequate sensitivity and an increase in the stimulation threshold due to the development of epicardial fibrosis due to previous defibrillation, as well as battery depletion. If the patient reports that the implantable cardioverter defibrillator is not functioning properly, the device can be tested to determine the cause.

trusted-source[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13]


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