Limitations of an ICD

Watch CRY’s myheart cardiologist, Dr Michael Papadakis, talk about the limitations of an ICD below.

As the technology develops, new devices come into the market. So for the conventional ICD, what you’re required to do is you need to make a small cut under the left collarbone in most individuals, then find the veins that go down to the heart, introduce a single wire, or two wires in some instances, and then connect it to a big battery that stays under the skin or under the muscle. Now, as the technology progresses, those sorts of devices thankfully become smaller and smaller, so it’s a bit more bearable and easier for individuals to carry them. But the other technology that has been developed is what we call a subcutaneous ICD. And essentially in that instance, you don’t need to introduce any wires within the heart. But you’re able to put a device that usually goes under the left armpit, and then you’ve got two wires under the skin at the front and the back of the heart. And essentially the benefit with that ICD is that you don’t have wires in the heart, so if something untoward was to happen, any complication with the defibrillator, then they’re far easier to take out- compared to a wire that has been in your heart for a long period of time- like four or five years, which can be very difficult and quite challenging to take out. The disadvantage that they’ve got is that obviously you require a higher degree of energy, a higher degree of shock, which what it may involve is a greater degree of discomfort for that particular individual, and as far as exercise and contact sports are concerned, now with a subcutaneous ICD, you’ve got a lead that is quite superficial as well, which means that you need to be a bit more careful compared to someone who has the lead that goes directly into the heart. So you don’t have the extra protection that your body’s ribcage will provide to that particular lead.

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