Cardiologists at the Intermountain Medical Center Heart Institute made Utah heart history Tuesday as doctors implanted Utah’s first subcutaneous implantable cardiac defibrillator to treat South Jordan resident Brandon England, 20, who suffers from heart failure and is at risk for sudden cardiac arrest.
England was diagnosed with dilated cardiomyopathy in April 2013, which affects the ability of the lower (ventricle) and upper (atria) chambers of the heart to effectively pump blood throughout the body. This type of heart disease places patients at risk for sudden cardiac arrest or an abrupt loss of heart function.
It’s the first time this technology has been used in Utah.
“We’ve been using the traditional transvenous ICDs for many years to treat cardiomyopathy with great success,” said Jeff Osborn, MD, cardiologist with the Intermountain Medical Center Heart Institute. “But having wires placed directly into the heart has its risks, including broken wires and life-threatening infections that we sometimes see five to seven years after implantation. This new device offers less risk with the same life-saving benefit.”
Rather than placing insulated wires into the chambers of the heart, the new S-ICD is placed under the skin across the ribcage and has two main components: the pulse generator, which powers the system, monitors heart activity, and delivers a shock if needed, and the electrode, which enables the device to sense the cardiac rhythm and serves as a pathway for shock delivery, when necessary.
During the procedure, a pocket is made in the skin below the left armpit, allowing the pulse generator to sit up against the ribcage. A durable electrode is tunneled under the skin along the ribcage to the center of the chest, then turns 90-degrees and follows the breastbone toward the neck.
“The S-ICD system would be similar to having the two AED paddles placed on the chest at all times, monitoring the heart and providing a shock, if necessary, to reset any chaotic heart rhythm, but with all the equipment buried under the skin,” said Dr Osborn. “In a young patient like Brandon, this new procedure will allow him to have a life-saving system close at hand, without the risks associated with wires running into his heart.”
More than 359,000 Americans suffered an out-of-hospital cardiac arrest in 2013, with a 9.5 percent survival rate, according to the American Heart Association.
Most episodes of sudden cardiac arrest are caused by the rapid and/or chaotic activity of the heart known as ventricular tachycardia or ventricular fibrillation, says Dr. Osborn. Recent estimates show that approximately 850,000 people in the United States are at risk of sudden cardiac arrest and would benefit from an ICD device, but remain unprotected.
The U.S. Food and Drug Administration initially granted regulatory approval for the S-ICD System in September 2012. To date, more than 2,000 devices have been implanted in patients around the world, with the Intermountain Medical Center Heart Institute the first Utah center to implant the device.
Thanks to this new technology now available in Utah, the future for Brandon and other heart patients is bright.
HD footage from the procedure is available. If you're interested in accessing that, please email firstname.lastname@example.org for the link and password for download.