What is ICD implantation?

This technology has been proven to be effective in preventing sudden out-of-hospital cardiac death. icd (embedded cardioverter-defibrillator) has been proven to be effective in preventing sudden out-of-hospital cardiac death. icd invention and its clinical application have provided an effective treatment for malignant cardiac arrhythmia, and icd implantation technology has been increasingly utilized in the clinical setting. Transvenous electrode lead implantation: Since 1994, transvenous unipolar defibrillation systems have been used in clinical practice. At present, the clinical application of non-open-chest implantation of icd system can be broadly divided into two categories according to the composition of defibrillation electrodes: 1, defibrillation system based on intracardiac coil electrodes: Although the design of each manufacturer is different, the right ventricle of the three-polar perception and defibrillation electrodes are basically the same, and the transvenous implantation of endocardial three-polar perception and defibrillation electrodes is followed by a coil electrode for defibrillation. This coil electrode needs to form a defibrillation circuit with another electrode. These systems in clinical application, most patients can get satisfactory defibrillation effect, but there are still a small number of patients can not get satisfactory defibrillation threshold, and switch to other non-open ICD system or open implantation of ICD system. 2, unipolar defibrillation system: unipolar defibrillation system refers to the defibrillator shell itself as a defibrillation of an electrode, and the coil defibrillation electrode in the heart constitutes the defibrillation circuit. This system has the following characteristics: ① The surgical operation is further simplified, only one three-pole sense and output electrode needs to be implanted via the tendon, and the defibrillator is buried directly under the skin or under the pectoral muscle in the left chest, and the defibrillation circuit is formed by the coil electrode in the right ventricle and the defibrillator casing in the left chest; ② The defibrillation threshold is low because the defibrillator casing serves as a defibrillation electrode, which greatly increases the area of the defibrillation electrode, and thus further effectively lowers the defibrillation threshold. Defibrillation Threshold Test: After the sensing and defibrillation electrode leads are fixed, the electrodes are connected to the external defibrillation test system for defibrillation value determination. To perform the defibrillation threshold measurement, ventricular fibrillation needs to be induced first. There are two methods of inducing ventricular fibrillation: one is t-wave shock, which induces ventricular fibrillation with a low-energy shock during the t-wave vulnerable period, and the other is 50-hz alternating current (AC) stimulation, both of which are very effective in inducing ventricular fibrillation. Although the criteria for defibrillation threshold vary, most hospitals use two consecutive effective defibrillations of 20 j or less energy as the success criterion, i.e., the defibrillation threshold is equal to or less than 20 j before the electrodes are considered to be continuous with the pulse generator and the pulse generator is implanted. After completing the threshold determination, the pulse generator was connected to the electrodes to induce ventricular fibrillation, and the function and effect of the whole icd system in sensing arrhythmia and defibrillation were examined. Implantation of defibrillator: At present, defibrillators commonly used in clinical practice are buried in the patient's chest, as a pole of the unipolar defibrillation system, the defibrillator must be buried in the left chest. icd chest implantation can be buried in the sub-muscular pouch or subcutaneous pouch depending on the patient's subcutaneous tissues of the chest, if the patient is thinner and has less subcutaneous fat, the icd can be buried in the sub-muscular, for the patient with more subcutaneous fat, the icd can be buried in the subcutaneous pouch. Subcutaneous capsule.