Analysis results Implantable cardioverter defibrillators (ICDs) have become an indispensable aid in the treatment of many patients with severe forms of tachycardia and cardiac arrhythmias. These devices are life-saving therapy in case of rapid heart contractions or sudden cardiac arrest. Traditionally, an ICD is implanted in the area of the left shoulder, near the collarbone. With the help of radiography, special wires are inserted through a vein into the heart, then through a valve and attached to the inner wall of the heart.
When ICD detects a dangerous situation, it sends an electrical impulse to the heart and normalizes its rhythm of contraction. However, in cases such as a malfunction of the device, the appearance of infections or the expiration of its service, it is removed. And this procedure also requires a lot of experience and skills from medical professionals.
Thus, the UMC Heart Center hosted a master class on transvenous extraction of cardioverter defibrillator electrodes in patients with severe infectious risks and damaged electrodes. A group of experts from Russia, the Center’s team and doctors from regional clinics participated in the training. Together they performed 4 surgeries to remove the device, including a series of lectures on methods and indicators for removing electrodes, risks and benefits of procedures for patients. The training allowed the specialists to exchange experiences and improve the extraction methods of the device.
Also, as part of the master class, an expert from Italy presented the technology of implantation of the subcutaneous EMBLEM™ S-ICD System, which provides a safer alternative. This device does not require the insertion of an electrode into the heart, but is placed under the skin above the sternum. The pulse generator itself is placed on the left side of the chest, next to the ribs. Thus, the EMBLEM system does not affect the heart and blood vessels. This makes the device suitable for patients of different ages, reducing the risk of serious complications and, if necessary, making extraction easier and faster.
“It is important to note that during the implantation of the new system, the Serratus regional anesthesia technique was used to reduce discomfort for the patient during the procedure, as well as to eliminate the use of general anesthesia, thereby speeding up the recovery of patients after the procedure,” added Omirbek Nuralinov, Head of Interventional Arrhythmology at the UMC Heart Center.
The new system was successfully implanted in 3 patients, all are in satisfactory condition. The procedures took place as part of the training and became a useful experience for the specialists of the UMC Heart Center. In the future, the acquired knowledge will be used in practice to improve the quality of medical services, patient health and transfer experience to regional colleagues.
