The device offers provides protection for patients at risk of sudden cardiac arrest, leaving the heart and blood vessels untouched.
New Delhi. In a path breaking development, doctors at the Fortis Escorts Heart Institute implanted India’s first Subcutaneous Implantable Defibrillator (S-ICD) in a 48 year old heart patient from Bihar, giving him a new lease of life. The S-ICD System is approved for patients who are at a risk of sudden cardiac death due to life threatening ventricular arrhythmias and those who do not require a pacemaker. The patient was treated by Dr Ashok Seth, Chairman-Fortis Escorts Heart Institute and Dr Anil Saxena, Director of Cardiac Pacing and Electrophysiology, who implanted the device.
The patient Mr. Arvind Sahay, 48 years, had suffered damage to his heart from a large heart attack in October 2014, and his heart was pumping at a low efficiency of only 25-30 per cent. He had undergone angiography and angioplasty with three stents after the heart attack and was breathless on occasions. In view of his poor heart function and the risk of sudden death, the decision to implant the subcutaneous ICD was taken.
Dr. Ashok Seth, Chairman Fortis Escorts Heart Institute, said, “Sudden cardiac death is a major public health problem in India and accounts for about 10 per cent of all deaths in India. Nearly 80 per cent of these deaths are due to ventricular arrhythmias, a large number of which can be prevented by timely resuscitation. Implantable defibrillators (ICDs) have changed the outlook for such patients, by significantly reducing risk of sudden cardiac death and totally external subcutaneous ICD is a landmark advancement in this direction”.
The subcutaneous ICD is an innovative device which does not require any leads to go into the chamber of the heart for its functioning unlike the other previous devices. It is totally external and under the skin only. With advantages of this device, more and more people suffering from heart diseases can be treated with this implant. The technique offers benefits such as lower risk of infection, no puncturing of the veins in the heart, and lesser chances of complications, over time. However, despite its advantages as the device cannot pace the heart, some patients who need the ICD are not suitable for this Subcutaneous ICD.
Dr. Anil Saxena, Director of Cardiac Pacing and Electrophysiology said, “S-ICD lead is implanted along the rib cage and breast bone. It is found to have success rates comparable to conventional ICDs, with lower complication rates. In particular, the rates of infections reaching blood stream, and lead failure have been less. S-ICD offers special advantage for younger patients who need ICD therapy for longer periods, and therefore placement of leads inside the heart poses more long term risks. As one does not need to puncture any veins to go to inside of the heart, this device is safe and easier to implant and the procedure takes approx. 1-hour under local anaesthesia and sedation only. With more developments in the future, the device is expected to get cheaper also.”
Added Dr Saxena, “Another major breakthrough with this device is that it can be implanted in pediatric patients, as young as two years of age, offering better application in this segment. As it is implanted subcutaneously, it can also be a huge relief for diabetics who have to opt for this as it has a smaller and faster window to recovery.”
