By Jana Soeldner Danger
When someone is at risk for sudden cardiac arrest, a defibrillator implanted into his or her body can be a lifesaver. The device delivers a shock that can restart the heart and restore its function.
Until recently, implanting a defibrillator required the physician to thread electronic leads through the patient’s veins and into the heart itself. Now, for some patients, there is an alternative: the Boston Scientific S-ICD System, a defibrillator the doctor implants just under the skin, leaving the heart untouched and reducing the risk of vascular injury and infection.
Most incidents of sudden cardiac arrest are caused by rapid or chaotic heartbeats, conditions that can be treated with the new technology.
Here’s how it works: The physician implants a pulse generator at the side of the patient’s chest which powers the system, monitors heart activity and delivers a shock if needed. An electrode implanted beside the breastbone allows the device to sense the cardiac rhythm and serves as a pathway for the shock delivery.
“It detects the heart’s electrical impulses wirelessly, so the patient has the protection of the device without having any hardware in the heart,” says Dr. Rishi Anand, medical director for the electrophysiology department at Holy Cross Hospital in Fort Lauderdale, where the device has been used about a dozen times.
The S-ICD System’s sophisticated technology can identify and classify the heart’s rhythms rather than its individual beats, making it more effective, Anand says. Another advantage: The new technology preserves access to the veins and reduces the risk of infection. “It’s easy to remove,” Anand says. “With the older system, there was the risk of infection in the bloodstream. With this device, if there is an infection, I just make a small cut and take it out.”
The battery in a defibrillator must be changed every five to seven years, so easy removal makes the system especially good for children, teens and young adults who may live with a defibrillator for decades.
The S-ICD System is appropriate for a broad range of body types – but it is not for everyone, Anand cautions. Many patients who require a defibrillator also need a pacemaker, and the S-ICD System does not include one. “Most modern defibrillators also have a pacemaker component,” he says. “The new system has only the shocking component. But it gives us another useful option for our patients.”