Automatic Implantable Cardioverter Defibrillator (AICD)

C. Prabakaran

Staff Nurse, Cath Lab, Kauvery Hospital, Tirunelveli, India

Abstract

Background

A 60 years old female was admitted with the complaints of palpitation and giddiness for four days. After the history collection and investigation, the consultant planned to do Holter monitoring. The Holter monitoring showed VT, AF and SVT. So, the patient was diagnosed as a tachy-brady syndrome. Then, planned to install AICD.

Examination

CVS: S1, S2 is normal
RS: Bilateral air entry is present
P\A: Soft, Non tender
CNS: NFNS
SAO2: 98%
BP: 130/70
HR: 70 to 100 beats\min
RR: 20 breaths\min

Investigation

ECG

ECHO

MRI scan

Holter Monitoring

Provisional diagnosis

Tachy Brady syndrome.

Procedure

Patient underwent Automatic Implantable Cardioverter Defibrillator (AICD).

Medications

Inj. Cetil – 1.5 g
Inj. Amikacin – 500 mg
Inj. Para – 1 g
Inj. Rantac
Tab. Cardarone – 200 mg
Tab. Concor cor – 2.5 mg
Tab. Lonazeb – 0.5 mg
Tab. Shelcal – 500 mg
Syr. Pulmoclear

Diet advice

Normal diet as well as the balanced diet.

Nursing management

The following advices are given to the patient while discharging,

Always carry an ID card that states you have an ICD. In addition, you may want to wear a medical ID bracelet showing that you have an ICD.
If you travel by air, inform security screeners that you have an ICD before going through the metal detector. (It may help to say you have a pacemaker which is true as pacemaker functions are built into ICDs because security may not know what an ICD is). In general, airport security detectors are safe for pacemakers and ICDs, but the small amount of metal in the device and leads may trigger the alarm. If you are selected for additional screening, politely remind the screener that the security wand contains a magnet, which may interfere with the programming or function of the ICD (pacemaker) if it is held over the device for more than a few seconds.
Anti-theft systems or electronic article surveillance (EAS) used in department stores may interact with an ICD. Do not lean on or stand on this equipment. But it is OK to pass quickly through the detection system.
Avoid large magnetic fields such as power generation sites and industrial sites, such as automobile junkyards that use large magnets.
If an MRI has been recommended for you, contact your doctor. Some newer ICDs are compatible with MRI scanners with some restrictions.
Do not use diathermy (the use of heat in physical therapy to treat muscles). Do not use a heating pad directly over your ICD.
Avoid transcutaneous electrical nerve stimulation (TENS) therapy. Talk to your doctor if you are considering this treatment.
Turn off large motors, such as cars or boats, when working on them as they may create a magnetic field.
Avoid high-voltage and radar machinery, such as radio or television transmitters, electric arc welders, high-tension wires, radar installations, or smelting furnaces.
If you are scheduled for surgery, let the surgeon know well ahead of the operation that you have an ICD. Also, consult with your cardiologist before the procedure to find out if you need any special preparation.
When involved in a physical, recreational, or sporting activity, protect yourself from trauma to the ICD. A blow to the chest near the ICD can affect its functioning. If you are hit in that area, you may want to see your doctor.
Cell phones are generally safe to use, but keep them at least 6 inches away from your ICD. Avoid carrying a cell phone in your breast pocket over your ICD.

Outcome

On the day of discharge, the patient was hemodynamically stable.

Automatic Implantable Cardioverter Defibrillator (AICD)