and A.M. All authors have read and agreed to the published version of the manuscript. an ICD if you have a known life threatening arrhythmia or a condition that increases the chance of developing one. Due to the categorization of patients according to the presence or absence of ICD prior to LVAD implantation, essential differences regarding the perioperative risk (e.g., INTERMACS profiles), the timeframe of HF history leading to LVAD implantation, and the occurrence of previous VAs are present between groups, potentially confounding survival analysis. Apart from comparable patient demographics and most outcome-relevant comorbidities, we found several essential differences regarding patient characteristics between both groups due to the non-randomized retrospective study-design. Defibrillator cardioverter discharges are associated with concerns about an ICD and affect a number of patient behaviors, including treatment adherence, disease acceptance and chronic disease functioning. . The scale is characterized by both a high sensitivity and specificity [, The Athens Insomnia Scale (AIS) is a self-reporting tool comprising eight statements about the various symptoms of insomnia. permission provided that the original article is clearly cited. Gender differences in psychological distress and quality of life in patients with an ICD1-Year postimplant. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, Implantable Cardioverter Defibrillator (ICD). The median follow-up was two years. Eur Heart J. Of note, 43.6% (41/94) of ICD-group patients underwent CRT-D implantation prior to LVAD-implantation. Of note, ICD implantation in patients with end-stage HF awaiting heart transplantation (HTx) appears to result in an immediate and sustained reduction of mortality (6). Highly respected national organization You may go home the same day or you may need to stay overnight in the hospital. It is a minor operation performed under local anesthesia. Cantillon DJ, Tarakji KG, Kumbhani DJ, Smedira NG, Starling RC, Wilkoff BL. J Am Coll Cardiol. She previously worked in basic science research and literature curation before switching gears to write and edit medical content in the consumer-focused digital health field. Patients with a primary prevention indication experienced a reduction in ICD anxiety and depression, and elderly patients had a reduction in anxiety during the follow-up period. The scale is highly reliable—the Cronbach’s alpha coefficient was 0.88 for the negative emotion subscale, whilst it was 0.84 for social inhibition [, The Acceptance of Illness scale (AIS) is a tool designed to measure the degree of disease acceptance in adults. JACC Heart Fail. An ICD can be programmed to give low-energy or high-energy shocks. The rate of concomitant procedures was higher within the Control-group [Table 2], mainly due to an increased prevalence of simultaneous ECMO and Impella explanation (54.4% (37/68) vs. 13.8% (13/94) (p < 0.001). An implantable cardioverter defibrillator (ICD) is a device implanted to regulate irregular heart rhythms. Paper should be a substantial original Article that involves several techniques or approaches, provides an outlook for The doctor tests and programs the device then closes the skin. We retrospectively analyzed baseline, perioperative and follow-up (FU) data of 162 consecutive patients who underwent cf LVAD implantation at our institution between 2010 and 2019. Go to source ICD group; p = 0.2) (Table 3). doi: 10.1111/aor.14234, 12. Articles, This article is part of the Research Topic, https://doi.org/10.3389/fcvm.2023.1158248, https://www.frontiersin.org/articles/10.3389/fcvm.2023.1158248/full#supplementary-material, Creative Commons Attribution License (CC BY). ; supervision, A.M.; project administration, O.K. Left ventricular dilatation increases the risk of ventricular arrhythmias in patients with reduced systolic function. It is good for slow, fast, and uncoordinated heart rhythms. A low-energy shock can feel like a flutter or thump in your chest. Patients at risk and cumulative deaths at each timepoint are displayed within the Kaplan-Meier plots. These include ventricular tachycardia (VT) or ventricular fibrillation (VF). Conclusion: ICD therapy in LVAD recipients was not associated with a survival benefit or reduced morbidity after LVAD implantation. This will help them make medical decisions if you have a medical emergency and are not able to tell them about the device. Overall survival during FU. Priori SG, Blomstrom-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, et al. Zungsontiporn, N.; Loguidice, M.; Daniels, J. The personality type was assessed using the DS-14 scale, the acceptance of the disease, as well as the occurrence of symptoms of anxiety and depression, insomnia and the severity of concerns related to the implanted ICD, were assessed in all of the patients who were included in the study. ; Kuhl, E.A. Depending on the type of ICD you get, the device may be able to store data about your heart rhythm and keep a record. Furthermore, despite the lack of a uniform “programming-protocol”, which is of highest importance to standardize device-programming in LVAD-recipients, there were no major changes regarding ICD-programming and follow-up schedule. The details are presented in, Comparison of the number of fears, their severity and other components of the ICDC scale showed an intensity of the effect, which was statistically more significant in women than in men. Each of the statements can have a score from 1 to 3 points. https://doi.org/10.3390/ijerph18116095, Karczewska O, Młynarska A. Your doctor will test your ICD regularly. Normally distributed continuous variables are presented as mean values and standard deviation. Metal detectors for security, such as those at airports. Ein implantierter Defibrillator kann lebensrettend sein. Mańkowska-Załuska, B.; Nowek, A.; Topolska, E.; Oszczygieł AChudzik, M.; Wranicz, J. They are more serious than other types of arrhythmias, such as atrial fibrillation (AFib). Test the system again before sending you to recovery. Living With Your Implantable Cardioverter Defibrillator (ICD) You may find living with an ICD scary, especially if you made the decision quickly due to sudden cardiac arrest (SCA). Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements. Clerkin KJ, Topkara VK, Demmer RT, Dizon JM, Yuzefpolskaya M, Fried JA, et al. The researchers say these findings underline the need for better education and awareness around defibrillators, so that they are used more frequently. This study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of the Medical University of Silesia in Katowice 30 October 2018 (Resolution KNW/0022/KB/224/I/18). *Correspondence: Jonas Pausch j.pausch@uke.de. JACC Heart Fail. ; formal analysis, A.M.; investigation, O.K. J Am Coll Cardiol. (2000) 21(24):2071–8. A significance level of 0.05 was adopted in the analysis. Vakil K, Kazmirczak F, Sathnur N, Adabag S, Cantillon DJ, Kiehl EL, et al. Artif Organs. Clinical characteristics and outcomes of patients with ventricular arrhythmias after continuous-flow left ventricular assist device implant. Thank you for taking the time to create a comment. Of note, within the first two years after LVAD-implantation additional 6 patients underwent elective generator exchange without complications. P-values reflecting log-rank test between both groups. ICD processes can vary widely. An ICD is also known as an implantable defibrillator or a defibrillator implant. Implantable cardioverter defibrillators are implanted to restore normal heart rhythm and prevent sudden cardiac death. Das einzig wirksame Verfahren, um dieses Risiko zu verringern, ist die Implantation eines Defibrillators oder kurz ICD (Implantierbarer Cardioverter Defibrillator). Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Median time to LVAD implantation after ICD implantation was similar in both subgroups (18 (8–44) months in the primary prev. Overall-survival during a median follow-up of 14 (3.0–36.5) months was similar within both groups (p = 0.46). The funders had no role in the design of the study; in the collection, analyses or interpretation of the data; in the writing of the manuscript or in the decision to publish the results. prevention ICD-implantation, electrophysiological studies and catheter-based VT ablation prior to, or after LVAD implantation, as well as surgical VT ablation during LVAD implantation, might become a valuable therapeutic option. Some technology can interfere with an ICD’s function. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. Keep reading to learn about ICD surgery, including how it is done, potential complications, and what to expect before, during, and after the procedure. During the first 2 years after LVAD implantation 53 ICD-related AEs occurred in 40 ICD-group patients (42.5%). The data to determine the minimum number of individuals within the group was obtained from the EHRA White Book 2017 [. The authors are aware of the non-randomized retrospective study-design limited to a single center. Recovering from your procedure Defibrillators device support Recovering from your procedure What to expect from recovery A full recovery from an implantable defibrillator (ICDs and S-ICDs) procedure can take a few days or a few months. This study was a single-center study, and the patients included in the study were from one region. (Figure 2A). No special They can also result in cardiac arrest. A defibrillator implant is minor surgery. Advertising on our site helps support our mission. Before enrolment, participants were informed about study confidentiality, its purpose and methodology. Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, et al. In May 2023, Frontiers adopted a new reporting platform to be Counter 5 compliant, in line with industry standards. Participation in the study was anonymous and voluntary. Cardiovasc. You need to know that you are not alone or without support. (2002) 346(12):877–83. Der plötzliche Herztod verursacht großes Leid und wirft noch viele Fragen auf. 1 - 3 In those trials, >7000 patients were randomized to appropriate heart failu. Implantable cardioverter-defibrillator in Brugada syndrome: Long-term follow up. Thomas IC, Cork DP, Levy A, Nayak H, Beshai JF, Burke MC, et al. Absolute numbers and percentages are used for categorical variables. Please let us know what you think of our products and services. If you think you may have a medical emergency, immediately call your doctor or dial 911. The implantable cardioverter-defibrillator (ICD) is standard of care for patients with potentially life-threatening ventricular arrhythmias and those at high risk of sudden cardiac death [1, 2].Defibrillation testing (DFT) has traditionally been part of the implant procedure of the ICD to confirm adequate defibrillation and appropriate sensitivity of the device. Implantable Cardioverter Defibrillator (ICD). It can restore a more regular rhythm and prevent cardiac arrest. Antiarrhythmics vs implantable defibrillator study. The AIS is one of the most commonly used scales, both for diagnostic purposes and in research into the effectiveness of treating insomnia. Important parameters for implantable cardioverter defibrillator selection. An AED increases the chance of survival If it senses one, it will deliver a strong shock to get the rhythm back to normal. ICD implantation is generally safe. 162 consecutive LVAD recipients were retrospectively categorized according to the presence (ICD-group; n = 94) or absence (Control-group; n = 68) of ICD prior to LVAD implantation. According to the decision of our multidisciplinary heart failure team, elective generator exchange was declined in this individual case to avoid the risk of potential bleeding complications and infection. doi: 10.1016/j.hrthm.2017.10.036, PubMed Abstract | CrossRef Full Text | Google Scholar, 2. Nevertheless, ongoing VAs might increase the risk of RHF, which is associated with rehospitalization and an impaired survival in this patient cohort (17). The occurrence of insomnia correlated with the severity and occurrence of fears after ICD implantation (number of fears r = 0.44, Additionally, a multiple regression model using the stepwise input method was performed. Our results are consistent with those presented by Vazquez et al. (2022) 328(12):1233–42. AVID, CASH and CIDS studies. Both symptoms were assessed using the HADS questionnaire and were more common for patients who expressed a high number of concerns in the ICDC [, The aim of a cohort study by Versteeg et al. The dependent variable was the number of concerns. Primary prophylaxis patients did not experience any negative effects of the disease, which resulted in no influence on the assessment of mental functioning [, In the present study, women had more intense concerns after ICD implantation. The battery-powered device constantly tracks heart rate and rhythm. You may have to avoid strenuous activities for about a month after surgery. Apart from ischemia-induced arrhythmogenic substrates, myocardial fibrosis due to non-ischemic dilated cardiomyopathy increases the risk of VAs as well (15). Your privacy is important to us. Carry an ID card that identifies your ICD device. J. Environ. The transvenous approach is the most common procedure. R Foundation for Statistical Computing. Everything to Know, What to Know About Wolff-Parkinson-White Syndrome, High Cholesterol: 7 Things Doctors Want You to Know. Its pulse generator delivers an electric shock when needed to correct arrhythmia. Arrhythmias can interrupt the flow of blood from your heart to the rest of your body or cause your heart to stop. By nixing these five types of foods and beverages from your diet, you’ll stay healthier and make it easier for your heart to do its job. Here are some common questions that may help you create your own list. Living with heart failure requires careful management of your symptoms and lifestyle. Apart from an increased prevalence of perioperative right heart failure (RHF) within the Control-group (45.6% vs. 17.0%; p < 0.001), procedural characteristics and perioperative outcome were similar. In 18 patients, appropriate shocks without the loss of consciousness occurred, whereas inappropriate shocks occurred in 5 patients. No use, distribution or reproduction is permitted which does not comply with these terms. Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely Raczak, G.; Sominka, D. Indications for implantation of a cardioverter-defibrillator. The ICD sends a shock to restore a normal heart rhythm. In addition, 2 patients had to undergo unplanned reoperation due to pocket hematoma after elective generator replacement due to battery depletion, whereas 1 patient underwent ICD-explantation due to pocket infection one month after elective generator replacement. In most cases, you can lead a normal life with an ICD. As there are conflicting reports regarding the benefits of biventricular pacing in LVAD recipients (1), LV lead settings were maintained after LVAD implantation, unless LV lead dysfunction occurred, and reprogramming was mandatory. The early identification of high-risk patients in terms of disorders such as anxiety or depression would enable the appropriate cardiac rehabilitation to be implemented and integrate them with psychological support, which would reduce anxiety and improve their quality of life [. Patients who experienced discharge had more concerns. Galand V, Flecher E, Auffret V, Boule S, Vincentelli A, Dambrin C, et al. For a subcutaneous ICD, the doctor makes an incision to the left of the breastbone to install the device and leads. 5 Foods to Avoid When You Have Heart Failure. Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS, et al. Conditions often treated with ICDs include: A cardiac surgeon or an electrophysiologist implants an ICD. An ICD continuously monitors the heartbeat and delivers electric shocks, when needed, to restore a regular heart rhythm. (22), a significant number of ICD-group patients (20.2%) developed lead-dysfunction, leading to an increased risk of VA-under- or -oversensing and inappropriate shocks (24). Although VAs are commonly well tolerated due to the ongoing cardiac output via cf LVAD, some LVAD recipients might develop right heart failure (RHF) (10). The omission of items related to somatic complaints has made the HADS scale one of the most commonly used screening tests in medical settings. It's usually placed just below the collarbone and connected to the inside of the heart by thin leads threaded . Sudden trouble walking, dizziness, loss of balance or coordination Sudden or severe headache with no known cause Nausea with uncontrolled vomiting Severe bleeding When do I need to seek medical attention? interesting to readers, or important in the respective research area. Meta-analysis of the implantable cardioverter defibrillator secondary prevention trials. The greater the severity of anxiety, the higher the results of the ICDC questionnaire subscale (number of concerns r = 0.66. The exclusion criteria were a previously diagnosed mental illness, cancer in the active phase, incomplete data, advanced heart failure suitable for resynchronization therapy, a previously implanted antiarrhythmic device and failure to attend a follow-up appointment. Thus, all the, All patients were reviewed at follow-up. How do ICDs work? According to interdisciplinary heart team discussion, individualized decision making determined the appropriate therapeutic option. Most people return to light to moderate activities within a few days but check with your doctor. The leads carry the shock to your heart. In our study, according to Pedersen’s observations, elderly patients showed less intense concerns about ICD implantation. Overview Implantable cardioverter-defibrillator (ICD) An implantable cardioverter-defibrillator (ICD) is a small battery-powered device placed in the chest to detect and stop irregular heartbeats (arrhythmias). Additionally, inform the care team of any allergies or past allergic reactions you have experienced. Nevertheless, multivariable adjusted Cox regression analysis could exclude independent impact of the differing baseline characteristics on survival [Table 4]. Vazquez, L.D. Kaplan-Meier curves including patients at risk and cumulative deaths: Overall survival analysis during follow-up after LVAD implantation (timepoint 0) (A, B). Individual statements were assessed using a 5-point scale: 0—false, 1—rather false, 2—hard to say, 3—rather true and 4—true. Furthermore, the prevalence of previous short-term circulatory support devices prior to LVAD implantation was higher within the Control-group 54.4% (37/68) vs. the ICD-group 13.8% (13/94) (p < 0.001) and Control-group patients were more frequently categorized as INTERMACS profile I or II [Table 1]. N Engl J Med. Frohlich GM, Holzmeister J, Hubler M, Hubler S, Wolfrum M, Enseleit F, et al. The study by Młynarska et al., a cross-cultural adaptation of ICDC, showed that the Polish language version of this questionnaire is valid and reproducible and can be used with Polish patients who have ICDs [. Materials and Methods: This was a prospective and observational study including 158 patients. New Advances in Cardiac Implantable Electronic Device Therapy, View all
ObjectivesImplantation of implantable cardioverter defibrillators (ICD) reduces the risk of all-cause mortality in symptomatic heart failure (HF) patients with severe left ventricular (LV) dysfunction. For more information, please refer to Access the subclavian vein and put the wires into the heart chambers. ICD group vs. 4.5 (1–12) months in the secondary prev. Recovery time varies. In contrast, patients with left ventricular dysfunction were more likely to experience increased anxiety. Last reviewed by a Cleveland Clinic medical professional on 05/15/2022. Most people with ICD live as they usually would. Nevertheless, the prevalence of cardiogenic shock and the rate of perioperative RHF was higher within the Control-group. Preoperative testing may include: Tell your doctor about all medications, vitamins, and herbal supplements you take. Just before you go home, your healthcare provider may test the ICD system again. This feature enables it to deliver shocks to stop ventricular fibrillation or cardiac arrest. Qualification of Drivers; Exemption Applications; Implantable Cardioverter Defibrillators (ICDs) A Notice by the Federal Motor Carrier Safety Administration on 05/18/2023. Stage II consisted of a follow-up appointment after six months ± two weeks following ICD insertion. 2 patients underwent RV-lead revision due to lead dysfunction 20 and 21 months after LVAD-implantation. Pacemakers and implantable cardioverter defibrillators (ICDs) are heart devices. Get useful, helpful and relevant health + wellness information. Patients were categorized according to the presence (n = 94, ICD-group) or absence (n = 68, Control-group) of ICDs prior to LVAD implantation (Figure 1). Heart Rhythm O2. Implantable cardioverter defibrillator (ICD). (2010) 7(4):466–71. Furthermore, an increased risk of hematoma and infection after planned or unplanned ICD-reintervention should be taken into consideration during shared decision making to avoid unnecessary complications in LVAD recipients. For someone at high risk of sudden cardiac death due to a specific heart rhythm problem, a health care provider will likely recommend an implantable cardioverter-defibrillator (ICD) rather than an AED.An ICD is implanted in the chest and connected to the heart through a wire that can deliver a shock when needed. It contains eight statements that describe the negative consequences of poor health, such as any limitations imposed by the disease, lack of self-sufficiency, a sense of dependence on third parties and lowered self-esteem. They place the pulse generator under the skin and attach the leads. But sometimes implantation requires open-heart surgery. chest pain, pressure, or squeezing sensation. A total of 162 consecutive symptomatic end-stage HF patients underwent cf LVAD implantation at our institution between 2010 and 2019. The ICD can: A 2015 study in the Journal of the American College of Cardiology showed that remote monitoring increases survival. Patients with type D personality and high levels of preimplantation concerns had a poorer survival rate compared to patients with one or none of these risk marker [, In another study by Pedersen et al., 32% of the patients experienced anxiety and 28% experienced depressive symptoms. The current study was a subgroup analysis of a larger project focused on factors related to ICD concerns. Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. Use of this website and any information contained herein is governed by the Healthgrades User Agreement. No significant differences were present in ICD- vs. Control-group regarding most outcome relevant comorbidities, nevertheless the prevalence of ischemic cardiomyopathy was higher within the Control-group. AB declared consulting activity for Abiomed, as well as travel grants and speaker honoraria from Abbott and Abiomed. The study was conducted in two stages: stage I before implantable cardioverter defibrillator (ICD) implantation and stage II follow-up visit six months after ICD implantation. The details are presented in. Patients were categorized according to the presence (n = 94, ICD-group) or absence (n = 68, Control-group) of ICDs prior to LVAD implantation (Figure 1). El-Battrawy, I.; Roterberg, G.; Liebe, V.; Ansari, U.; Lang, S.; Zhou, X.; Borggrefe, M.; Akin, I. It is composed of seven statements related to anxiety and seven statements related to depressive states. The leads are not in the heart. The subcutaneous implantable cardioverter-defibrillator (S-ICD) was introduced to reduce acute transvenous lead-related complications, such as pneumothorax, endocarditis, cardiac perforation, and lead dislodgements, as well as the complications related to chronic indwelling leads, such as lead failure, venous obstruction, and bacteremia. But, as with any surgery, the procedure comes with risks, including: If you have an ICD, carry a card in your purse or wallet to alert emergency personnel. However, some ICDs can function as pacemakers, too. Pedersen, S.; Hoogwegt, M.; Jordaens, L.; Theuns, D. Pre-implantation psychological functioning preserved in majority of implantable cardioverter defibrillator patients 12 months post implantation. Implantable cardioverter-defibrillators in patients with a continuous-flow left ventricular assist device: an analysis of the INTERMACS registry. doi: 10.1016/j.healun.2015.05.018, 18. Thereof, 6 patients required RV-lead revision due to immediate postoperative RV-lead dysfunction after LVAD-implantation. positive feedback from the reviewers. Subgroup analysis according to ICD-indication was performed and patients were therefore categorized in primary vs. secondary prevention ICD patients. doi: 10.1056/NEJMoa033088, 5. The automatic implantable cardioverter-defibrillator: efficacy, complications and survival in patients with malignant ventricular arrhythmias.