Health Team

New, less-invasive cardiac device helps Triangle patients

Posted April 16, 2014

With a history of heart-related issues, Robert Wall needed something that would help keep his heart beating properly.

Wall, 81, became the first Triangle patient to receive a new type of implantable cardiac defibrillator, or ICD, that never touches the heart.

WakeMed cardiologists implanted the ICD under Wall's skin to help prevent sudden cardiac death. More than 850 thousand Americans, like Wall, have arrythmias, or irregular heartbeats.

"He said it would help me improve a lot," Wall said.

Doctors typically embed an ICD under the skin of the chest with a wire going through a vein directly into the heart. When the heart goes out of rhythm, it's shocked back to normal. With the model Wall received, the device is under the arm with the wire crossing under the skin only.

Cardiologists say the new model involves a simpler procedure than a standard intravenous ICD because it's just under the skin instead of leading into the heart. The procedure is done under general anesthesia and most people can go home the same day. The new device works much the same way an external defibrillator would when placed above the skin, said Dr. George Hamrick, a WakeMed electrophysiologist.

While a subcutaneous (under the skin) ICD probably isn't going to replace a standard ICD because that one also functions as a pacemaker for people with slower heartbeats, the new model has it's advantages, Hamrick said.

With the standard ICD, risks like infection or a worn wire from constant motion are high.

"In those cases, the lead often needs to be extracted and extraction procedures carry risk of tearing the heart or tearing vessels," Hamrick said.

With the newer model, infection rates are much lower.

The new ICD is also a big advantage for some dialysis patients who ordinarily wouldn't be able to get the standard model because of a vein obstructed by a catheter or patients who may have clots or blockages that wouldn't allow for the wire lead to the heart.

"So it's a more durable lead. Less prone to infection. Less prone to vascular complications," Hamrick said.

Wall and his wife Jackie are both glad that it's there – ready to work when needed.

"I think he feels more comfortable," Jackie Wall. "He doesn't feel as fearful."



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