Insertion of AICD usually recommended in
- Patients with ventricular tachycardia
- Patients who have had severe myocardial infarction
- Patients with congestive heart failure
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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.
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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.
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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
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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