Our last ICDC event was April last year and the Cardiologists and pacing physiologists would be interested to know if the ICD community would like another Educational Event.
I talked about what we do when someone's ICD gives them a shock. We have some interesting questions and comments. It turns out that electric fences for chickens deliver a 2 Joule shock whereas ICDs deliver an internal shock of between 20-40 Joules so holding an electric fence will not treat ventricular arrhythmia so is not recommended.
Dr Adam Jacques discussed heart conditions that may require an ICD and have a genetic basis so could be passed on to children. Cardiology is moving on from preventing disease in the individual to preventing and detecting disease in the family. Dr Jacques has a specialist interest in a hypertrophic cardiomyopathy and now runs a dedicated clinic looking after these patients and screening relatives.
Dr Riyaz Kaba is a relatively new addition to the cardiology team at SPH and has a special interest in heart rhythm management. He presented on how we decide who needs an ICD.
A few people have asked me about which make of ICD is the best. Companies include Biotronik, Medtronic, Boston Scientific/Guidant, Sorin/ELA and St Jude's. The devices are getting better all the time and the most modern devices can be checked wirelessly and remotely on the mobile phone network. There is no device that is clearly superior. Like cars there a variety of attributes used when selecting a device. Some smaller hospitals only work with one or two companies so that they don't have to learn how to service all the devices. Just like cars e.g. the old Citroën with its inflatable suspension, some Cardiologists are big fans of certain devices whereas others prefer not to use them. The most important point to stress is that all devices have undergone extensive testing and development and there are no 'bad' devices on the market currently. The is a robust international monitoring mechanism and any concerns about ICDs is quickly communicated to us so that we can make necessary adjustments to reduce the risk of device malfunction. All this and more at our next event.
Dr Ian Beeton