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Implantable Defibrillators Can Save Your Life, But Some Contain Defects

separator People who have the most serious kind of heart arrythmias—called ventricular tachycardia and ventricular fibrillation—are at high risk of sudden cardiac death. This occurs when a problem with the heart’s rhythm keeps the heart from pumping blood to the brain and to vital organs.

If you have one of these serious heart rhythm conditions, your doctor may probably talk to you about having an implantable cardioverter defibrillator, or ICD, placed in your chest. Many experts believe that an ICD gives people at high risk the best chance of avoiding cardiac death.

ICDs, which are about the size of a pager, are placed below your collarbone. Wires connected to the ICD monitor your heart’s rhythm. If your heart beats so quickly that the ventricles don’t fill up with enough blood to pump throughout the body, the ICD sends electrical stimulation to the heart to restore normal beating. People who have an ICD report that the stimulation feels like a kick in the chest. That can sound scary, but it’s important to remember that it can save your life.

Reports of defects in some ICDs
You may have read or heard that defects have been found in some ICDs. The flaws are rare, but they can cause some of the units to short-circuit. The Food and Drug Administration (FDA) has reported that about 20 in 1,000 of the ICDs contain the defects, and that they’ve caused 31 deaths between 1990 and 2002.

Even if you have an ICD that has the defect, the chances that it would affect you are slim. However, the flaw can prove to be fatal if the ICD short circuits just at the moment when you need it to work for you. In March of 2005, a college student in Minnesota, Joshua Oukrop, died when his ICD short-circuited.

What to do if you already have an ICD?
The FDA is working on ways to improve its regulation of ICDs, but that’s no help to patients who already have the devices implanted in their chests. Many doctors believe that the benefit of an ICD far outweighs its risks. Only you and your doctor can decide whether you should replace your current ICD with a new one. Your doctor will talk to you about the risks of having the ICD removed and having another one implanted, against the risk of continuing on with your current ICD.

Some people decide to keep their current ICD because they feel comfortable enough with the small risk that it could fail. Others don’t want to take that risk, however small. It’s a frustrating decision to have to make, but talking with your doctor will help you come to the choice that’s right for you.

Source:
Food and Drug Administration; The Heart Rhythm Society; The New York Times, “FDA had Report of Short Circuit in Heart Devices,” 12 September 2005.



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