Defibrillator Placed Under Skin Saves Lives

Every 90 seconds in the U.S., someone dies from sudden cardiac arrest (SCA) — when the heart suddenly stops beating, triggered by an electrical malfunction in the heart. For people at risk for SCA, an implantable cardioverter defibrillator (ICD) can be a lifesaver.

An ICD is a small battery-powered device that’s surgically placed in the chest. It continually monitors a person’s heart rhythm. When it senses the heart is beating dangerously fast or erratically, the ICD delivers a dose of electricity to restore a healthy rhythm.

New Defibrillator Option

Until recently, all ICDs on the market have required insertion of wires, called leads, into a vein in the upper chest and into the patient’s heart. Now, there’s an FDA-approved device — S-ICD® — with leads that are implanted just under the skin (subcutaneously). Instead of being connected directly to the heart, the ICD is implanted along the bottom of the rib cage and breastbone.

If there is a problem with implanted ICDs, it’s almost always due to the wiring. The subclavian vein is the main access point for most traditional ICDs. When wires are placed into that vein, in up to one-third of the time, scar tissue will severely narrow or even close off that vessel completely.

Removing a traditional system often requires extraction tools such as laser sheaths that cut away scar tissue all the way into the heart. These procedures have a small but serious risk of damaging blood vessels and the heart itself.

By having no leads in the blood vessels or heart, the new S-ICD also avoids the problems that come with removing them.

Are You a Candidate for an S-ICD?

So who’s a candidate for the new subcutaneous ICD? The answer: Anyone who needs a simple system that will protect them from potentially dangerous heart arrhythmia that can lead to sudden cardiac arrest. Traditional ICDs function as both a defibrillator and pacemaker, while the new S-ICD is a defibrillator alone.

The S-ICD also is particularly well suited for younger patients who are likely to need the system for 20 years or more (and therefore are most at risk for developing a lead problem over time). Additionally, patients at high risk for infection (which can be more severe when leads are inside blood vessels), and those who’ve had previous difficulty with standard ICDs are good candidates.

It’s also a terrific new option for patients who need a defibrillator but have been reluctant to get one because of concerns about hardware being placed inside their blood vessels and heart.

Today, only about 25 percent of patients who should get a defibrillator is actually referred for one. These patients and their doctors have concerns about lead issues. This new ICD addresses these concerns, offering patients an effective alternative to traditional ICD for the prevention of sudden cardiac arrest.

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