Subcutaneous defibrillator can correct irregular rhythm without touching the heart
||Michael Kim, MD
The Cardiovascular Institute at Rhode Island, The Miriam and Newport hospitals is the first in the state to implant a new leadless implantable cardiac defibrillator (ICD). The device, the S-ICD System by Boston Scientific, is the first subcutaneous ICD for the treatment of patients at risk for sudden cardiac arrest and is the only ICD that does not require electrical wires to be placed in the heart.
“More than a half-million people in the United States are treated each year for sudden cardiac arrest,” said Michael Kim, MD, director of the arrhythmia service at Rhode Island Hospital, where the ICD was implanted. “This new defibrillator provides patients with an alternative option to single and double-lead defibrillators, and may be safer for many patients. It is a less invasive procedure, which often means a reduced risk of complications and faster recovery. Additionally, many patients may be able to have the S-ICD implanted on an outpatient basis, allowing them to return home immediately following the procedure.”
The S-ICD is implanted under the skin and leaves the heart and blood vessels intact. When cardiac arrest is detected, the electrode delivers a shock to the heart similar to single- and double-lead implantable defibrillators and external defibrillator paddles. Even without directly touching the heart, the electrode can deliver a shock that corrects the heart’s rhythm. The first patient received the new ICD in late January.
The S-ICD System has two main components: a pulse generator, which powers the system, monitors heart activity, and delivers a shock if needed; and the electrode, which enables the device to sense the cardiac rhythm and serves as a pathway for appropriate shock delivery. Both components are implanted just under the skin — the generator at the side of the chest, and the electrode beside the breastbone.
ICDs are used in patients who are being treated for ventricular complications, particularly those who have sustained a cardiac arrest, had at least one episode of ventricular tachycardia or other cardiac issues.
About the Lifespan Cardiovascular Institute
The Cardiovascular Institute (CVI) of Rhode Island, The Miriam and Newport hospitals is the largest center in the state dedicated to cardiology and cardiac surgery. Services are provided by teams dedicated to providing high quality, innovative patient care and performing clinical trials and cutting-edge research at the CVI’s Cardiovascular Research Center. All care is provided by board-certified physicians and surgeons who also serve as faculty at The Warren Alpert Medical School of Brown University. Services include cardiovascular imaging and surgery; interventional cardiology; echocardiography and stress testing; electrophysiology; congenital heart program; the medical heart failure and cardiac transplant program; advanced valve management; and more. Rhode Island, The Miriam and Newport hospitals are all part of Lifespan, the state’s largest health system.