What is it?

An Automatic Implantable Cardioverter Defibrillator, (AICD), is a small electronic device that is implanted into your chest to monitor and correct an abnormal heart rhythm, or arrhythmia. These devices are used to treat serious and life-threatening arrhythmias.

The procedure takes about 1 hour

For any patient enquiries please speak to your cardiologist or contact Mildura Cardiology by phone (03) 5023 8111 or email [email protected] 

Procedure Information

What to bring

+ Any concession cards including Medicare and private heath fund cards.
+ All current medication in its original packaging.

* For all procedures requiring overnight stays, please ensure you bring with you night attire, including dressing gown, non-slip slippers and toiletries.

Pre-procedure

+ Carried out in a sterile theatre at either Mildura Base Hospital or Mildura Private Hospital

+ Patients can expect to be in hospital for at least 1 night

+ An ECG will be performed and you may also have blood taken

+ You will be required to fast for 6 hours prior to procedure.

* Your cardiologist will advise any cessation of blood thinning medications prior to procedure.

Procedure

+Patient receives light sedation for relaxation. You will be awake but drowsy.

+ An area below the collar bone will be numbed with local anaesthetic and a small incision made (approx 5-8cms) to insert the AICD.

+ Leads are then guided through a vein into the heart and connected to the device.

+ The skin is then sewn together and a small dressing applied.

+ Our Pacing Technologist, present during the procedure will program the defibrillator

+ Upon returning to the ward you will have your heart rhythm and blood pressure monitored.

+ An ECG and chest X-ray will be taken.

+  Rest in bed is required for 24 hours following procedure to allow  device leads to settle into place.

+ The wound site will be observed for swelling and bleeding. Pain relief for wound discomfort will be given if required.

Public patients will undergo this procedure at the Mildura Base Hospital, while those patients with private health fund insurance will be accommodated at Mildura Health Private Hospital.

Post care

Patients will receive a visit from a Cardiac Nurse from Mildura Cardiology who will;

+ Interrogate your AICD to assess the settings and if any treatment has been delivered

+ Give you an information booklet detailing information about living with an AICD

+ Provide you with a temporary ID card to carry regarding your new device, your permanent card will arrive via mail and should be carried with you at all times

+ Give you an appointment to see the Cardiac Registrar at Mildura Cardiology for the following week

+ Give you an appointment to have your device checked at Mildura Cardiology 1 month post implant

+ You will be also be given appointment to see the surgeon who implanted the AICD 10-14 days post implant.

Discharge

Patients undergoing an automatic implantable cardioverter procedure will be required to stay overnight with discharge being the following day.

* It is important to discuss with your Cardiologist instructions for dressing removal and wound care. Once the dressing(s) has been removed it will require little care. Keep clean and dry and avoid using powder. Check wound daily and report any possible signs of infection to your Cardiologist promptly.

+Your cardiologist will discuss a time for a follow up appointment (Usually within a week or two).

+ You will be discharged with the appropriate medications.

^ Please discuss any limitations or restrictions directly following your procedure and any medication changes with your Cardiologist.

fi If you have travelled from regional or remote centres, your Cardiologist may advise you to stay in Mildura for 2-3 days following your procedure.

Depending on your procedure, time and recovery you will be discharged the same day or early the next morning provided you’re accompanied by an consenting adult. Your cardiologist will arrange a follow up appointment prior to discharge.

For 24 hours following procedure, it is recommended you do not;

+ Drive a vehicle

+ Travel on public transport

+ Drink Alcohol

+ Sign important documents

+ Use heavy machinery

Following discharge

+ Do not lift your arm above shoulder level (on the side that the AICD was implanted), or lift any heavy objects for the first 4 weeks.

+ Do not drive until the AICD site is no longer tender and the Cardiac Registrar has given you permission.

Since these are life-saving devices they do need to be monitored closely to ensure that the system is working normally and that inappropriate shocks are minimised. Patients will need to have regular appointments with their cardiologist so that they can test the AICD. These are usually arranged for 1 day post implant, 1 month post implant and then every 3 months.

Risks

Although serious problems are rare, as with any medical procedure there are always some risks involved. Every effort is made to minimise your risk, though should complications arising from you procedure occur, emergency equipment is readily available.

Exact risks vary from patient to patient, however, some symptoms that may occur include;

Haematoma (Bruising and swelling)

It is usual for most patients to have bruising and tenderness at and around the catheters insertion point for a few days following procedure.

Infection

Infection is rare, however if infection does occur it is usually contained to the area of skin overlying the catheter insertion point. Any infection will be treated with the appropriate antibiotic.

Allergic reaction to dye

A dye, or ‘Contrast’ is used to enable the coronary arteries to be seen using x-ray. Minor reactions can result in hives and rare occasions where a dramatic fall in blood pressure is evident, shock. Risk to patients with no previous reaction to contrast dyes extremely low. Inform your Cardiologist if you have had any previous reaction to contrast mediums.

Acute Closure or rupture of coronary artery

In rare cases, coronary angioplasty can cause the artery to become completely blocked or rupture. In this situation an emergency coronary artery bypass operation would be performed.

Heart Attack

In extreme cases, patients may endure cardiac arrest during this procedure. Rest assured your Cardiologist is well prepared to deal with this situation.