ICD & Device Therapy for Heart Failure
Device therapy, including ICDs (Implantable Cardioverter Defibrillators) and CRT (Cardiac Resynchronization Therapy), plays a critical role in the advanced management of heart failure. These technologies are designed not only to improve the quality of life but also to significantly reduce the risk of sudden cardiac death and enhance overall heart function in eligible patients.
Implantable Cardioverter Defibrillator (ICD)
An ICD is a small electronic device implanted under the skin, usually near the collarbone. It continuously monitors the heart’s rhythm and automatically delivers life-saving shocks if it detects dangerous arrhythmias such as ventricular tachycardia or ventricular fibrillation. These arrhythmias can lead to sudden cardiac arrest if not promptly treated.
ICDs are typically recommended for patients who:
Have survived a cardiac arrest
Have experienced life-threatening ventricular arrhythmias
Have a significantly reduced ejection fraction (≤ 35%) due to heart failure or after a heart attack
The device can also function as a pacemaker, offering dual functionality in certain cases.
Cardiac Resynchronization Therapy (CRT)
CRT, also known as biventricular pacing, is a specialized type of pacemaker therapy used to treat heart failure caused by poor coordination of the heart’s contractions, often due to left bundle branch block (LBBB). CRT devices send electrical impulses to both the left and right ventricles to help them beat in a more synchronized manner.
CRT is particularly beneficial for:
Patients with moderate to severe heart failure (NYHA Class III or IV)
A reduced ejection fraction (≤ 35%)
A wide QRS complex on ECG (≥ 130-150 ms)
CRT devices come in two types:
CRT-P (Pacemaker only)
CRT-D (Pacemaker + ICD functionality)
Benefits of ICD and Device Therapy
Prevention of Sudden Cardiac Death
Improved Heart Pumping Efficiency
Reduction in Heart Failure Symptoms
Decreased Hospitalizations
Improved Quality of Life and Survival
The Procedure
Device implantation is a minimally invasive procedure performed under local anesthesia and sedation. The leads are guided through veins into the heart, and the device is programmed to suit the patient's specific condition. Patients are typically discharged within 24–48 hours and can return to daily activities shortly thereafter.
Follow-Up and Monitoring
Regular follow-ups are essential to ensure the device is functioning properly. Many modern devices offer remote monitoring capabilities, allowing for early detection of problems and fewer hospital visits.
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