Harvard Heart Letter

New options to reboot the heart

Implantable cardioverter-defibrillators can prevent sudden cardiac arrest. Now more people can benefit.

Miniature electronic devices called implantable cardioverter-defibrillators (ICDs) that detect and terminate rapid, irregular beats in the heart's lower chambers (ventricles)—a problem known as ventricular fibrillation—can be a lifesaver for people susceptible to deadly arrhythmias With recent technological advances, these devices are even safer and more available.

Wireless ICD devices

One breakthrough is an ICD placed under the skin in the chest that can sense and correct abnormal heart rhythms without the use of wires, called leads, implanted into the heart muscle. "There are huge issues with leads," says Dr. Jagmeet Singh, a cardiologist at Massachusetts General Hospital and associate professor of medicine at Harvard Medical School. "They can fracture, the wires may need to be extracted and replaced over time, and patients can get infections. Now, a patient who might not have been an ICD candidate in the past because of a high risk of lead infections would be a shoo-in for the device." Wireless devices may also have applications for younger people with congenital heart diseases. These individuals may need several ICD devices over their lifetime, so leadless technology could make ICDs more feasible for this group.

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