Name of the Procedure:

Lead, Cardioverter-Defibrillator, Endocardial Single Coil (Implantable)
Common name(s): Cardioverter-Defibrillator Lead, ICD Lead, Defibrillator Lead

Summary

This procedure involves the implantation of a specialized wire (lead) into the heart, which is connected to a cardioverter-defibrillator device. The device monitors heart rhythms and delivers electrical shocks if life-threatening arrhythmias are detected.

Purpose

Medical Conditions or Problems Addressed:

• Ventricular fibrillation
• Ventricular tachycardia
• Sudden cardiac arrest

Goals or Expected Outcomes:

• Restore normal heart rhythm
• Prevent cardiac arrest
• Prolong life expectancy

Indications

• Recurrent episodes of ventricular tachycardia or fibrillation
• High risk of sudden cardiac arrest due to underlying heart conditions
• Previous history of sudden cardiac arrest

Preparation

Pre-Procedure Instructions:

• Fasting for at least 6 hours before the procedure
• Adjustments to blood-thinning medications as advised by the physician
• Routine blood tests and electrocardiogram (ECG)
• Imaging tests like echocardiogram or chest X-ray

Procedure Description

1. The patient is placed under local anesthesia and sedation.
2. A small incision is made near the collarbone.
3. The lead is inserted through a vein and guided into the heart.
4. The position of the lead is confirmed via fluoroscopy (real-time X-ray).
5. The lead is connected to the cardioverter-defibrillator device, which is placed under the skin in the chest.
6. The incision is closed with sutures.

Tools and Technology:

• Cardioverter-Defibrillator Device
• Endocardial Lead
• Fluoroscopy equipment

Anesthesia:

• Local anesthesia with sedation

Duration

The procedure typically takes 1 to 2 hours.

Setting

• Hospital operating room or catheterization lab

Personnel

• Cardiac surgeon or electrophysiologist
• Nurses
• Anesthesiologist
• Radiology technician

Risks and Complications

Common Risks:

• Infection at the incision site
• Bleeding or bruising
• Pain or swelling

Rare Risks:

• Lead dislodgement
• Damage to blood vessels or heart
• Device malfunction

Possible Complications:

• Managed through medication, additional procedures, or device adjustments

Benefits

• Reduced risk of sudden cardiac death
• Effective management of arrhythmias
• Improved quality of life

Realization:

• Immediate monitoring and protection once the device is activated

Recovery

Post-Procedure Care:

• Monitoring in a hospital for 24 to 48 hours
• Wound care guidelines
• Avoid heavy lifting and strenuous activities for 4-6 weeks

Expected Recovery Time:

• Full recovery within 4-6 weeks

Follow-Up:

• Regular follow-up appointments to check device function

Alternatives

Other Treatment Options:

• Medication management
• Catheter ablation
• External defibrillator

Pros and Cons:

• Medications and external defibrillators are less invasive but may be less effective in preventing sudden cardiac arrest.

Patient Experience

During Procedure:

• Minimal pain due to local anesthesia
• Sedation to ensure comfort

After Procedure:

• Tenderness and bruising at the incision site
• Possible discomfort from the implanted device initially
• Pain management with prescribed medications

Comfort measures and reassurance from healthcare staff will aid the recovery process.