ICDs Can Be Difference Between Life, Death

Preventing heart disease involves a healthy lifestyle including a healthy diet and regular exercise. But people presently at risk of heart attack may want to consider an implantable cardiac defibrillator (ICD).

Posted 6:39 p.m. Aug 1, 2007 — Updated 4:10 p.m. Aug 3, 2007

RALEIGH, N.C. — Health experts said sudden cardiac death is the leading cause of death in the United States, killing more than strokes, lung cancer, breast cancer and HIV-related illness combined. Sudden cardiac death is responsible for 325,000 American deaths each year.

Preventing heart disease involves a healthy lifestyle including a healthy diet and regular exercise. But for people who are presently at risk of heart attack, they may want to consider an implantable cardiac defibrillator (ICD).

Charles Toler has been diagnosed with heart failure, which is a weakened heart. Six months ago, he got an ICD in case of a cardiac arrest.

"If you were to go into a dangerous life-threatening heart rhythm, the ICD would recognize that heart rhythm, would treat it with an internal shock and convert you back to normal rhythm all within a period of about 6-1/2 seconds," said Dr. Kevin Campbell, a cardio electrophysiologist at WakeMed.

ICDs are implanted just under the skin of the chest with electric leads routed to the heart. Campbell said they can reduce a heart patient's risk of death by 30 percent.

Candidates are typically patients who have had a past heart attack or have weakened hearts for other reasons. Some people do not know they are at risk, but it could be revealed with a simple stress test and a measurement called an ejection fraction.

"It is technically the amount of blood pumped out of the left ventricle with each stroke of the heart," Campbell said.

Just like knowing your blood pressure or cholesterol numbers, Campbell said you should know your ejection fraction. The number should be higher than 35 percent. A normal ejection fraction is 55 percent.

Health experts said if the low ejection fraction leads to a heart attack, ICDs deliver a potentially life-saving shock. Toler said he has not needed a shock yet, but he is glad the ICD is there if the occasion arises.

"It's a lifesaver to me," he said.

Campbell said many people confuse pacemakers and ICDs. Pacemakers treat people with a slow heart rhythm. They pace the heart, but they do not deliver shock therapy. ICDs can also treat a slow heart rhythm and deliver a life-saving shock if necessary.

Many people are concerned about reports of ICD malfunctions. However, ICD technology is improving. Many models can now be monitored remotely, from places like the patients' own home, to make sure they are still functioning properly.

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