n implantable cardioverter defibrillator, known as an AICD, is a type of mechanical device implanted in the chest to help regulate and monitor the heartbeat. The device is similar to a pacemaker, in that it has "leads" that are situated inside the heart muscle or on the surface of the heart muscle to deliver small electric shocks that help pace the heart rhythm as well as read its function.
The implantable cardioverter defibrillator utilizes wires or "leads" that are situated inside the heart muscle. These leads are connected to what is called a pulse generator, or the major portion of the device, usually implanted under the skin in the abdomen or chest.
About the size of the deck of cards, the generator is capable of monitoring and correcting abnormal heart rhythm. Continuous advancements in technology are creating smaller devices that can actually be inserted through the blood vessels in minimally invasive surgical procedures.
If the defibrillator or generator identifies fibrillation, or ventricular tachycardia, meaning a faster heartbeat in the lower chambers of the heart, the device emits a small electrical shock that startles the heart and encourages it to restore normal rhythm.
An AICD can be programmed to recognize an accelerated as well as a slowed heart rate and adapts electrical impulses to the heart muscle accordingly. The AICD is battery-operated, and the length of life of the battery is determined by preprogrammed settings of the generator. Replacing AICD batteries is a simple procedure that can be completed in under an hour.
Individuals who have been diagnosed with sustained ventricular tachycardia, also known as ventricular fibrillation, as well as individuals diagnosed to be at a high risk of ventricular arrhythmias, or abnormal heart rates may benefit from the installation of an AICD.
Before the actual procedure to implant an AICD device, the patient will undergo an EP test or study. Known as an electrophysiological study, the test determines whether or not the patient will benefit most from an AICD or medication treatment for abnormal ventricular rhythms.
New technologies enable the devices to be implanted with minimally invasive surgical procedures, which can be done under local or general anesthesia. A small incision is made into the upper chest, directly beneath the collarbone. The cardiologist will thread one of the wires or leads into the heart through a vein. The AICD will be placed in the chest, to which the wire or wires to various locations in or on the heart muscle will be connected.
For a day or two following the implant procedure, the surgeon and staff, with the aid of a computer program, will test the device by actually creating arrhythmias or abnormal heart rhythms, during and after which the surgeon will watch to make sure that the AICD device delivers the required electrical impulses to correct the arrhythmia. Fine tuning will ensure that the device provides adequate shock or defibrillator to the heart muscle.
The cost of an AICD procedure depends on the model used, surgeons fees, and location of the hospital. Some AICDs can cost up to $40,000, again depending on location and model. In most cases, implantation of an AICD in the U.S. averages between $30,000 and $40,000. This cost may or may not include surgeon's fees, anesthesiology, and operating room costs. Some models in the United States may cost around $10,000, but does not include the cost of the operation or surgeon's fees. However, travelers to medical destinations in India, Central Europe, the Middle East, and South America may enjoy savings on both the implant devices and surgeons fees.
Cardiac surgeons must meet basic requirements and training for certification in various cardiac fields and techniques, as well as specialties. A cardiac surgery resident may stand anywhere from five to ten years training to become a fully qualified surgeon in cardiac surgery and procedures. Cardiothoracic surgeons typically complete a five-year general surgery residency, followed by two to three years of specialization in cardiothoracic surgeries. Various licensing boards that certify surgeons in cardiac surgery as well as subspecialties differ per country of origin. When looking for qualified cardiac surgeons in any country, look to national and statewide boards, associations, and memberships in specific cardiovascular specialties.
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