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Ventricular fibrillation and ventricular tachycardia can cause cardiac arrest and stop blood flow. Implantable cardioverter defibrillator (ICD) is the most effective treatment method and can significantly improve the survival rate of these patients.
There is about 5% chance of getting out of lead and requiring another operation. Before the usual 4-7 year replacement period, the risk of equipment failure is about 1%. For about 4 weeks, avoid raising the arm on the side of the defibrillator above the level of the shoulder to reduce the risk of pulling out the wire. There is a risk of damage to the wires, so repeated movements on the ICD side should be avoided for a long time.Depending on the patient's specific condition, there may be other risks. In this article we will talk about more.
The following knowledge points are listed below:
Defibrillator is the only option for treatment of ventricular fibrillation
Risks of using a defibrillator
Without defibrillation, the heart will continue to be in cardiac arrest. It is difficult to maintain sufficient circulation only with chest compressions. Chest compressions during cardiac arrest are part of cardiopulmonary resuscitation or cardiopulmonary resuscitation. So defibrillation is a life-saving method with no other choice. Since defibrillation involves the delivery of high-voltage electric shocks, multiple high-voltage electric shocks can cause a certain degree of damage to the myocardium. Myocardial injury is manifested by elevated myocardial enzymes in the blood and ST segment elevation of ECG. In the case of an implantable defibrillator shock, some transient heart rhythm suppression that requires backup pacing is also common. But in general, defibrillation is a safe method that can save lives.
In the case of implantable defibrillators, frequent electric shocks may reduce the quality of life because some people are afraid of electric shocks in accidents. Before implanting a defibrillator, a good consultation can relieve a lot of this anxiety. We can explain the fact that every electric shock is an opportunity to prevent potential loss of life.
The risks and contraindications of defibrillator depend on the type of defibrillator used.
A contraindication to defibrillation is the presence of pulse. If the patient is in the water, defibrillation should not be performed.
Defibrillator is two-way. If a defibrillator is used to shock a patient who has not experienced fibrillation, the heart may turn into fibrillation. Correct application of defibrillation is the most important consideration for this type of cardioversion.
If the patient's heart has already experienced ventricular fibrillation, there is no contraindication to defibrillation shock.
(1) Atrial fibrillation
The use of electrical defibrillator to treat atrial fibrillation may lead to stroke, pulmonary embolism, or myocardial infarction caused by thromboembolism. As we all know, patients with atrial fibrillation will form blood clots in certain parts of the heart, which are easy to fall off during cardioversion.
(2) Remind patients
The use of electrical defibrillator in awake and alert patients can cause significant discomfort, even if the cardioversion causes the symptoms and signs of the primary arrhythmia to cease. Healthcare providers control this by using sedatives, if the patient is stable enough to tolerate the sedative effect of waiting for a few minutes.
Before cardioversion, if the patient is not stable enough to wait for sedation, sedation is usually used afterwards to help the patient deal with the discomfort after shock. Patients often report retrograde amnesia effects after using sedatives after cardioversion and do not remember the actual procedure.
(3) Pharmacological risks and contraindications
The use of drugs to achieve cardioversion may produce a stronger response than expected. In these cases, it may be necessary to take corrective measures, whether it is electrotherapy or other medications. For example, if a patient overreacts to the use of atropine and develops ventricular tachycardia, electrical cardioversion can be used to restore the heart to a normal rhythm.
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