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Automated Implantable Cardioverter-Defibrillator (AICD)
Insertion of AICD usually recommended in
- Patients with ventricular tachycardia
- Patients who have had severe myocardial infarction
- Patients with congestive heart failure
During the AICD procedure
- The activity of heart is continuously monitored by ECG, all vital parameters are kept under check.
- The lead wire is inserted through the blood vessel with the help of an introducer and advanced into the heart.
- There may be one, two or even three lead wires inserted depending upon the device function required.
- After introducing one end of the lead wires to the heart the other is connected to the generator.
- Initial testing of AICD is done for its functioning and proper placement.
- After testing, the Generator containing the battery and the mini computer is placed under the skin through an incision generally in the left upper chest.
- The incision is then closed and dressing applied to keep it infection free.
After the AICD procedure
- The patient is kept under observation till blood pressure and other vital signs are stable .
- The ECG is monitored to observe the functioning of the AICD.
- Incision site will be sore, painful for a few days and will require painkillers for relief.
- Care should be taken to prevent infection by keeping the incision site dry and clean.
- The patient should avoid strenuous physical activity and lifting heavy weights or anything that puts pressure on muscles of chest and arm for few weeks.
Precautions with AICD Implantation
- Patient should always carry the AICD card
- Avoid keeping mobile phone on the side of AICD insertion as it may temporarily hamper with the function of the device.
- Let the medical physician know you have an AICD as certain investigations like MRI should be avoided, however recently MR-conditional ICD are being introduced.
- Do not use heating pad directly over AICD.
- Avoid physical trauma to the chest near the AICD insertion ,it may hamper the functioning of the device.
- As soon as patient receives an AICD shock ,he should get in touch with the consulting physician.
- If patient feels continuous tachycardia (fast heart rate ) for more than 2 minutes he should immediately contact doctor.
- Sometimes AICD may set off security alarm it is then required to explain about AICD insertion and show the medical card to the security.
- As AICD is a life saving device, It is mandatory to go for regular screening to check whether the device is functioning properly and also the battery life.
Diagnosis for AICD implantation
Usually diagnosis for AICD requirement is based on results of
- Heart monitoring
- ECG findings
- CT, MRI, chest X Ray correlated with clinical examination
Factors affecting cost of AICD implantation
The cost to the patient depends on a variety of factors like
- The hospital, the patient chooses
- Cost of the device
- Room –Standard single room, deluxe room, super deluxe room for the number of nights specified (including nursing fee, meals, room rate and room service)
- Fee for the team of doctors
- Standard test and diagnostic procedures
- Cost of the follow – up care required after the procedure