Related Experiment Videos
A Canadian hospital's experience with the automatic implantable cardioverter/defibrillator
A D Sharma1, G Guiraudon, G J Klein
1Department of Medicine, University Hospital, London, Ont.
Insights
The automatic implantable cardioverter/defibrillator (AICD) effectively treats life-threatening arrhythmias. This study shows AICD implantation improved survival and patient satisfaction in high-risk cardiac patients.
Area of Science:
- Cardiology
- Medical Devices
- Electrophysiology
Background:
- Recurrent ventricular tachycardia and ventricular fibrillation pose significant risks of sudden cardiac death.
- The automatic implantable cardioverter/defibrillator (AICD) is a device recently approved for clinical use.
- Patient selection for AICD implantation is critical, particularly those refractory to pharmacologic therapy.
Purpose of the Study:
- To evaluate the initial clinical experience with the automatic implantable cardioverter/defibrillator (AICD) in patients with recurrent ventricular arrhythmias.
- To assess the safety, efficacy, and patient satisfaction following AICD implantation.
Main Methods:
- A cohort of 12 patients with documented ventricular fibrillation underwent AICD implantation.
- Electrophysiologic testing was performed to assess inducibility of ventricular arrhythmias.
- Patients were followed for a mean of 15.5 months post-implantation.
Main Results:
- One in-hospital mortality occurred within 24 hours of implantation.
- No further deaths were observed during the follow-up period.
- All surviving patients reported satisfaction with the AICD, with several returning to work or school.
Conclusions:
- The AICD demonstrates favorable initial outcomes in selected patients with life-threatening ventricular arrhythmias.
- AICD implantation can improve survival rates and quality of life for at-risk individuals.
- The AICD holds significant potential for widespread use in managing sudden cardiac death prevention.
Abstract:
The automatic implantable cardioverter/defibrillator is a device that can be implanted in patients for treatment of recurrent ventricular tachycardia and ventricular fibrillation. It was recently approved for clinical use in Canada. The authors describe their experience with 12 patients (mean age 51.3 years) who underwent implantation of a defibrillator. All 12 patients had a history of documented ventricular fibrillation, which was idiopathic in 3 and due to ischemic heart disease in 9. Electrophysiologic testing revealed inducible ventricular tachycardia or ventricular fibrillation in 8 of the 10 patients tested. An important criterion for selection for implantation was failure of pharmacologic therapy to suppress ventricular arrhythmias induced during electrophysiologic testing. Of the 12 patients, 1 died within 24 hours after implantation. During a mean follow-up period of 15.5 months there were no further deaths. All the surviving patients expressed satisfaction with the device; five of the seven under the age of 60 years have returned to work, and one has returned to school. This initial favourable experience with the automatic implantable cardioverter/defibrillator suggests that future increases in the availability of the device and improvements in its function will lead to much more widespread use, as the population of patients at risk of sudden cardiac death is large.