Next generation ICD implantations begin at HUSKeywords:
Finland’s first extravascular implantable cardioverter-defibrillators (EV-ICD) have been implanted at HUS Heart and Lung Center. In Finland, next generation ICDs are currently only implanted at HUS, but HUS accepts patients from anywhere in Finland. Only a few hundred of the new ICD devices have been implanted worldwide.
Implantable cardioverter-defibrillators (ICDs) are used to treat life-threatening ventricular cardiac arrhythmia. The next generation device combines the best aspects of a traditional transvenous and the newer subcutaneous ICDs.
The EV-ICD is implanted completely outside of the heart and the blood vessels. The device’s lead is tunnelled under the breastbone, near the heart. This method of implantation avoids many late complications related to traditional ICDs, such as blocked veins and blood-borne infections of the ICD. When compared to a subcutaneous ICD, the EV-ICD is more versatile, longer-lasting, and smaller. The device's expected life cycle is more than 10 years, and the device is monitored at check-ups at the Pacemaker Outpatient Clinic and with automated remote monitoring.
The device treats life-threatening arrhythmia automatically with overdrive pacing or by administering defibrillation–i.e., an electric shock–during ventricular fibrillation. In the event of a sudden pause in the heart rate, the device provides back-up pacing to ensure sufficient heart rate.
Careful selection of patients
About 100 patients receive an ICD at HUS every year. The new EV-ICDs will be implanted as needed because they are not suitable for all patients.
“Patients who require plenty of pacing will receive a traditional device, and patients who suffer from irregular contractions of the left ventricle will receive a cardiac resynchronization therapy pacemaker. If we assume that the patient will require open-heart surgery later, we will choose a device with a transvenous lead”, explains Jarkko Karvonen, deputy chief physician in cardiology at HUS Heart and Lung Center.
“Now we have several good ICD options to choose from, and every patient can receive the type that is best suited for them. It is wonderful that our patients are among the first to benefit from new technology”, says Karvonen.