Implantable cardiovertor defibrillator(ICD) is one of the major revolution in cardiology practice that happened last century. We know , the number one killer of mankind is the ventricular fibrillation induced by acute or chronic CAD.
In the later half of 20th century we learnt that , the only way to prevent a sudden cardiac death is the defibrillating the heart as soon as the deadly killer arrhythmia strikes !
Whenever cardiac arrest happens in a susceptible population , following things are possible.
- Call 911 /108 start CPR .
- Have Automatic external defibrillator AED at home
- ICD implantation -Percutaneous trans-venous approach
And now new mode of defibrillation
Transvenous implantation becomes technically complex in many .Abandoning the procedure or using subcutaneous pads are necessary in few . Then , this question was asked
Why not the entire ICD implantation be in subcutaneous plane ?
Yes , it is possible . After all , current can reach the place where it is needed , irrespective of the site it is delivered. The aim of this technique is to simplify the ICD implantation , so that it can be practiced in a wider clinical set up Preliminary results of subcutaneous ICD are available and was published recently in NEJM.
The issues that need to be tackled are
- Amount of energy required
- Battery life
Dr.S.Venkatesan MD 
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