Harvard Heart Letter

On the horizon: An ICD that works without wires

Implantable cardioverter-defibrillators (ICDs) are small devices that detect potentially deadly heart rhythms, stop them with an electric shock, and restore a normal heart rhythm. Although ICDs are generally implanted in older people who have survived a heart attack, another use is in younger people whose seemingly healthy hearts lapse into the fast or erratic rhythms known as ventricular tachycardia and ventricular fibrillation.

Traditional ICDs are connected to the heart via thin wires called leads (pronounced leeds) placed through a large vein and then into the heart. Placing the leads through the vein is one of the trickiest parts of the procedure, and leads sometimes fail.

A California company called Cameron Health has developed a subcutaneous (under the skin) ICD that doesn't use leads. A surgeon implants the pulse generator under the skin below the left armpit and connects it to a flexible rod placed under the skin just to the left of the breastbone. Sensors on the top and bottom of the rod constantly monitor the heart. If they detect a dangerous rhythm, the center of the rod emits a jolt of electricity.

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