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This lesson describes what an AICD is and how it can be helpful for patients at risk of cardiac events. Learn more about this life-saving device, including just how safe and easy it is to insert!

What Is an AICD?

Think of the last time you walked up the stairs. Or, if you exercise, how you felt after a short run on the treadmill. It is likely that your heart was beating faster even before you started moving. Now, imagine that your heartbeat was trailing behind your intensity.

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Maybe instead the opposite was happening too: a low intensity workout pushing your heartbeat to a disturbingly high level. If this type of cardiac activity continues and the doctor diagnoses you with an abnormality, you may need surgery. Such instances can be alarming, but thankfully, technology is available to help control your heartbeat.An automatic implantable cardioverter defibrillator (AICD) is a small device, made up of a wire and body, used to continuously check your heartbeat. AICDs are extraordinary machines designed to help the pace of the heart and to deliver a shock, if needed. Overall, such devices can speed up or slow down your heart rate, with the ultimate goal of keeping your heartbeat as normal as possible.

Arrhythmia and Defibrillation

Think again of that instance when your heart sped up after a low intensity workout. It is likely that, after a few seconds, your heartbeat returned to normal. However, what if it did not stabilize, or it seemed to be beating at an aberrant interval? Irregular heartbeat is described as an arrhythmia, an abnormal rhythm of the heart (just remember ‘a’ for ‘arrhythmia’ and ‘abnormal’). AICDs are one of the methods used to treat arrhythmia. Unlike a pacemaker that continuously controls heart rate, an AICD is a sensor, monitoring your heartbeat for any inconsistencies.

The AICD can function in two main ways: providing low impulses to return the heart to a normal beating rate or delivering high-intensity shocks to protect against cardiac arrest. The intense shocks are called defibrillation and are meant to jolt the heart back into a normal rhythm. Think of Frankenstein when he was shocked to life. Often, this procedure can be lifesaving.

AICDs are normally given to patients with a high risk of a life-threatening cardiac event. For example, if you have already suffered from a heart attack, an AICD may be recommended. Additionally, if you have congenital heart disease or other heart-related syndromes, your doctor may suggest the device. No matter the reason, AICDs are a backup to your heart, providing a cushion in case of an emergency.

Placement of the AICD

Because of its relatively small size (about the size of a watch face), the placement of the AICD does not require major surgery, and recovery time is minimal.

Now let’s imagine that you are observing the surgeon as they place the AICD inside a patient. First, the patient’s vital signs are monitored during the entire length of the surgery, making sure that their heartbeat and breathing remain normal. Although the patient may receive some sedation, the surgery is often conducted while they’re still awake. However, in patients with pre-existing heart rhythm disorders (such as Brugada Syndrome), general anesthesia may be more safe than local anesthesia, which may accentuate arrhythmia.The doctor then inserts a catheter, which is a thin tube, into a blood vessel underneath their collarbone. The AICD wire (electrode) is then fed through the catheter, into the blood vessel, until it reaches the heart.

You watch the wire slowly move towards the heart through X-ray imagery, which helps the doctor visualize and guide the wire. Next, the wire is attached to the body of the AICD, and the device is implanted under the skin, typically near the collarbone. After some testing, the patient’s incision is closed, and the short recovery time begins. Overall, the surgery is not overly dangerous, and a small price to pay for a potentially life-saving support system.

Lesson Summary

Irregular heartbeat, or arrhythmia, may require an AICD, or automatic implantable cardioverter defibrillator. An AICD can be thought of as a backup for your heart, waiting for an abnormal heartbeat and then delivering a shock to return your heart rate to normal. The shock itself is referred to as defibrillation.

The AICD consists of a wire, which is placed in the heart through a blood vessel, and a body, which will be housed under your skin, oftentimes near the collarbone. AICDs are generally recommended for patients who have survived heart attacks or have a history of heart disease.Medical Disclaimer: The information on this site is for your information only and is not a substitute for professional medical advice.


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