Implantable Defibrillators saving lives

Photograph of Lauren Giudicatti
March 12, 2018

For most people, knowing the difference between a Pacemaker and an Implantable Defibrillator would be impressive.

For Royal Perth Hospital Cardiology Service Registrar Dr Lauren Giudicatti, understanding the intricacies of both life-saving devices, including when each device should be used in preference to the other, is an absolute essential.

As part of her training, Dr Giudicatti had the opportunity to study a unique case involving a 62 year old patient who was born with abnormal heart anatomy, and who had suffered a life threatening heart rhythm after a heart attack.

“The patient required an Implantable Cardioverter Defibrillator (ICD). This is a device a little larger than a Pacemaker which provides an electric shock to correct dangerous heart arrhythmias,” Dr Giudicatti said.

While these ICD devices are commonly inserted by Cardiologists specialising in Electrophysiology at Royal Perth Hospital, the patient’s unusual condition meant that the conventional Implantable Cardioverter Defibrillator, which uses wires inserted through large veins into the inside of the heart, was not suitable.

Instead, a Subcutaneous Defibrillator was inserted. This consists of an electrical generator, placed on the side of the chest, connected to a single wire placed across the chest wall beneath the skin. The wire rests near the heart but does not pass through veins and is not in direct contact with the heart itself.

The device can send electrical impulses in the form of a “shock” to correct dangerous heart rhythms and prevent the patient from experiencing sudden cardiac death.

The device is monitored wirelessly, providing an alert when it has been activated. In addition, when the patient attends check-ups, data can be downloaded by passing a ‘wand’ over the device, which is useful in assisting in the planning of ongoing treatment.

“This was the first case in WA where a patient implanted with this non-conventional subcutaneous device received a successful shock to correct a potentially life threatening arrhythmia,” Dr Giudicatti said.

“I was fortunate in my role to have had the opportunity to study this unique case, and to be a part of the team involved in the patient’s care.”