Automatic Implantable Cardioverter-Defibrillator (AICD)

What is it?

An Automatic Implantable Cardioverter Defibrillator, (AICD), is a small electronic device that is implanted into your chest to monitor and correct an abnormal heart rhythm, or arrhythmia. These devices are used to treat serious and life-threatening arrhythmias and are the most effective way of doing so.

Defibrillators treat arrhythmias in two ways: in the first instance the device tries to stop the abnormal rhythm with a burst of high speed pacing (cardioversion). If that fails, the device will deliver an electrical shock to the heart to reset its rhythm (defibrillation). Patients are usually not aware of cardioversion and nearly always aware of defibrillation. It is also capable of collecting and storing information about your heart’s electrical activity for your cardiologist to check.

Your cardiologist will program the defibrillator to deliver the best therapy for you.

Preparation

The  procedure will be carried out in a cardiology laboratory or 'cath lab'. Patients can expect to be in hospital for 1-2 nights. An ECG will be performed and you may also have blood taken. Fasting is required for 6 hours prior to the admission time. Blood thinning medication may need to be stopped a few days before the procedure; however your cardiologist will advise of this.

The procedure

The procedure takes about an hour. During this time you will be given some light sedation to help you relax and feel comfortable. You will be awake but drowsy. An area below the collar bone will be numbed with local anaesthetic and the cardiologist will make a small cut (approx 5-8cms) to insert the AICD. The leads are then guided through a vein into the heart and connected to the device. The skin is then sewn together and a small dressing applied.

On your return to the cardiac care unit you will have your heart rhythm and blood pressure monitored. You will also have an ECG and chest X-ray. You will be required to rest in bed for 1-4 hours or until the next morning depending on your doctor's orders.

The wound site will be observed for swelling and bleeding. Pain relief for wound discomfort will be given if required. 

Following discharge

You will stay in hospital for 1-2 nights and be discharged when your cardiologist is happy with your progress. You will receive an information booklet after your procedure detailing information about living with an AICD.

Some important points to discuss with your cardiologist prior to discharge are:

• Possible driving restrictions
• Possible medication changes
• Follow up appointment details
• Medic Alert bracelet application
• What to do if you receive therapy from your AICD

Since these are life-saving devices they do need to be monitored closely to ensure that the system is working normally and that inappropriate shocks are minimised. Patients will need to have regular appointments with their cardiologist so that they can test the AICD.

A follow up appointment will more than likely be organised for  2-4 weeks later in the consulting rooms.

If you are a patient undergoing this procedure and you have any further queries, please raise them with your cardiologist.

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