Dr Beeton writes...

On the ICDC Surrey Education Day, 16th April 2016

Our education day covered management of cardiac arrest, new technologies and questions regarding living with ICDs.

Sister Pat Little (Specialist Arrhythmia Nurse), Sister Therese (Specialist Heart Failure Nurse) demonstrated and taught on how to help an unresponsive person.  We pointed out that ICDs can treat cardiac arrest, but survival chances are improved when circulation and oxygenation are supported with cardiopulmonary resuscitation (CPR: chest compressions and rescue breaths). It is safe for the patient and resuscitator to perform CPR on someone with an ICD.  Remember to call for help (dial 999) when starting resuscitation.

Automated defibrillators (AEDs) are becoming very widely available and improve chance of survival from cardiac arrest in patients with and without ICDs.  When opened the AED will tell you exactly what to do.  In most cases ICDs do not get in the way of the adhesive defibrillator pads, but some patients have their ICDs on the right side and then the adhesive pads can be placed just below the left and right armpits.

During the break, family and patients received supervised practice on the method of chest compressions.  We recommend that everyone learns how to deliver effective chest compressions.

Peter Sawires from Boston Scientific brought us up to date with the new technology of subcutaneous ICD.  As with all ICDs the pulse generator (battery) is implanted under the skin, but the lead is also implanted under the skin whereas with conventional ICD the lead is within the heart.  Subcutaneous ICDs will have a small share of the market, but are suitable for very young patients to avoid having to have multiple lead changes throughout their lives.  Like all the different types of ICDs there are advantages and disadvantages.  We are fortunate to have a wide range of ICDs so that the best device can be chosen to suite each individual patient.

The questions and answers session this year was harder than previous years because people generally don't like to think about receiving a shock from their ICD.  Patients who haven't had a shock mostly want to know what it is like to receive a shock.  Some of our patients shared their experience of shocks.  Experience varies, but most agreed that it feels like a kick from inside and often there is a bruised feeling in the chest for a few days afterwards.  The psychological impact of having a shock can be quite significant.  When there is a shock the ICD Team try and prevent further shocks by reprogramming the ICD and/or giving medication to prevent further dangerous heart rhythms that may require a shock.  Overdrive pacing called antitachycardia pacing is one method to treat a dangerous heart rhythm called ventricular tachycardia before it degenerates into full cardiac arrest called ventricular fibrillation.  There is advice on this website and in the patient pack as to what to do in the event of a shock form one's ICD.

Thank you to everyone who came along to the ICDC Surrey Education Day. 
Please do keep in touch with your ICD questions.

New members always welcome.

Dr Ian Beeton

Consultant Cardiologist
Ashford and St Peter's Hospitals NHS Foundation Trust

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