Date: 2/11/2014

First in NW Indiana to use new lead-free defibrillator technology

The S-ICD’s main component — the pulse generator - is tucked away, barely noticeable under the patient’s arm and because of its positioning, does not limit the patient’s range of motion.

Patients at risk for sudden cardiac arrest in need a safety net for their heart have a less invasive option available with a new subcutaneous implanted cardioverter defibrillator (S-ICD). Electrophysiologist Raghuram Dasari, MD, on staff at the hospitals of Community Healthcare System, was first in Northwest Indiana to perform the defibrillator implant with an ICD that does not require leads in the heart. He completed the minimally-invasive procedure Feb. 5 on 26-year old Delanio Blackman at Community Hospital in Munster.

Boston Scientific’s S-ICD™ System is the world’s first defibrillator that does not connect to the heart with wires. The device delivers its lifesaving jolt without actually touching the heart. Instead, a lead runs beneath the skin from the device to just above the breastbone and uses a subcutaneous electrode to analyze heart rhythm to sense, identify then convert tachyarrhythmia or fibrillation.

“This is a very good alternative for our patients who have poor vascular access, such as vein narrowing and blockages, those prone to crush injuries in leads near the clavicle and ribs or those with a history of infections,” Dasari explained.

Other implantable defibrillators have leads that pass through a vein into the patient’s heart. Placement requires precision, threading the lead through a vein in the collarbone down into the heart’s lower chamber. When the wires or leads need to be removed years later after they fracture, move out of position or become infected; extraction becomes an even more delicate procedure, one that carries greater risk.

The S-ICD is not appropriate for every patient with heart rhythm disorders — it is not like a pacemaker that can speed up the heart beat for those with bradycardia or regularly correct a faulty heart beat.

“It is a good option for younger patients and those who need only a lifesaving shock when their heart goes into ventricular tachyarrhythmia mode,” Dasari said. “If someone is in their 20s or 30s or 40s and needs an implantable defibrillator, they could have it for 30, 40 or 50 years. The lead can fail and then it becomes a bigger concern. With the S-ICD, if anything does go wrong with the device after years and years, it can easily be removed since there is no lead attached to the heart.”

The S-ICD’s main component — the pulse generator - is tucked away, barely noticeable under the patient’s arm. Once implanted, the S-ICD System does not limit range of motion and most patients are able to resume normal daily activities — driving, traveling, exercise — within 10 to 14 days after the procedure.

Patients with the S-ICD device as well as most standard pacemakers are not able to have an MRI for imaging diagnostics. MRI scanners use a very powerful magnet to obtain images. As with other devices that affect the heart’s rhythm, an MRI can interfere with a defibrillator’s programming, turn off certain safety features or make them work incorrectly. A magnet can damage the existing device and potentially cause it to malfunction. For S-ICD patients in need of diagnostic imaging, other scanning methods are used to obtain detailed pictures from inside the body.

To find a cardiologist or electrophysiologist on staff at the hospitals of Community Healthcare System - Community Hospital in Munster, St. Catherine Hospital in East Chicago and St. Mary Medical Center in Hobart - call 219-836-3477 or toll-free 1-866-836-3477.