Device ICD saves millions of people with heart disease

On 21 June, ICD transplantation took place in Thong Nhat HCMC Hospital (Implantable Cardioverter Defibrillator - Implantable cardioverter defibrillator) for Dang Thanh Vinh San, 9 years old, with arrhythmia

This is one of the youngest cases ever to have an ICD, so she can live normally like everyone else, no longer obsessed with fainting episodes every time an arrhythmia or fear of sudden death occurs. This evil disease. In 1969, Michel Mirowski, a cardiologist in the Sinai Baltimore Hospital (USA) and his colleagues, began searching for a transplantable device with the function of "breaking" arrhythmias, bringing normal life for patients.

From the death of loved ones

The surgical crew with Dr. Minh (on the right) and Dr. Phuong are manipulating the heart support device inside her chest.

Born in Poland in 1924, after the Second World War, depressed by the bombardment of the bombardment, 21-year-old Mirowski went to Palestine to study medicine. There were no schools teaching this field here, so he returned to Europe, went to France to study and graduate in medicine in 1954. Graduation, Mirowski went to Israel to work at BV Tel Hashomer, where he became a digital assistant. 1 for Professor Harry Heller, who later inspired him to make an ICD.

Since the work became more and more stable, Mirowski was invited to work at the Asaf Harofeh Hospital, 15 miles from Tel Aviv, as a cardiologist. In 1966, Prof. Heller suffered from ventricular tachycardia (a dangerous arrhythmia) and then died and died while having dinner with his family. Witnessing the death of the teacher and friend, Mirowski questioned the prevention of sudden deaths by implanting a machine that could destroy arrhythmias.

In fact, at that time, medicine was able to solve this with an external electric shock. But the inconvenience of the machine is heavy, bulky, only solved for emergency hospitalized patients. For patients with arrhythmias far away from the hospital, death is almost certain.Why not shrink the device to the size of a pack of cigarettes and transplant it on the patient to be able to resolve the arrhythmia at any time? - Mirowski wondered. However, by consulting with other cardiovascular experts, everyone says this is . unbelievable! Undeterred, Mirowski went to America because he knew that only here he had financial and technical support to fulfill his dream. He was accepted to work in Baltimore's Sinai Hospital and quickly became head of coronary artery treatment. Within 12 years, from 1969, Mirowski and colleagues persisted in studying ICD. In 1980 ICD was established, and on April 2, 1980, ICD implants were conducted for the first case in the world. In 1985, the US Food and Drug Administration (US-FDA) approved the circulation of ICDs, which are indicated for patients who have suffered 2 cardiac arrest.

Savior of cardiac arrhythmia patients

The mechanism of ICD operation is not too complicated. Installed on the patient's left chest, under the skin or under the muscle, the electrodes of the machine are connected to the heart to record abnormalities. Every time the heart beats too fast and irregularly, the machine will emit a few tens of joules in 15 - 20 seconds to bring the heart rate back to normal. More interestingly, when the heart rate is too slow due to the use of cardiac support, the machine can " click " the heart to beat faster.

The pacemaker is already in the baby's chest.

The success of an ICD has dispelled many previous doubts. Even Bernard Lown, the father of an external manipulator, has also said: "For patients with severe arrhythmias, it is best to pursue a medication or surgical program to adjustment of abnormalities in the heart. ICD transplantation is not an effective solution ". However, many clinical studies have demonstrated the superiority of ICD compared with antiarrhythmic drugs in preventing sudden cardiac arrhythmias.

In 1999, the study of 1,016 patients, US scientists found that in the group taking antiarrhythmic drugs, the number of sudden death from the disease was 122 people, higher than that of the ICD group, only 80 people. Similarly, a study published in 2005 showed a 23% decrease in the number of patients who died after ICD placement compared to patients who only took placebo.

More than 20 years after its inception, ICD has been improved. At first to pair the machine, one must open the chest and place the support device in the patient's abdomen. Today, grafting is improving, less invasive, no need to open the chest. For pediatric patients, the doctor needs anesthesia, but for large patients, only need anesthesia, while the transplant is fully awake and the patient can talk to the doctor.

Previously, the device was placed in a box, only emitting high energy when the patient's heart rate exceeded, today it is programmed to generate both low energy and high energy to solve many arrhythmias in the heart. . The new generation can also memorize all arrhythmias, the number of effective electric shocks with the energy intensity, the number of times the electric shock fails, thereby allowing the doctor to better understand the condition of the disease. Multiply, install the electric shock power accordingly. From a heavy, bulky machine originally, the ICD today weighs only 70 grams and is 12.9 mm thick. Battery life has also increased, lasting more than 6 years compared to 2 years in the first generation.

Over the past 20 years, thanks to an ICD, millions of cardiac arrhythmias have escaped sudden death, living as normal as everyone else. It is known that the US Vice President himself, Richard Bruce "Dick" Cheney, is also carrying an ICD on him. A very heavy smoker, suffered from cardiovascular disease and was treated many times by vascular bypass surgery, stent placement, in 2004, Cheney received an ICD. In March of this year, Cheney was hospitalized for deep vein thrombosis.

Phan Son - Photo: Le Quang Nhat

ICD transplant for Vinh San successfully

Dr. Ton That Minh, the main surgeon placed a pacemaker on the chest of a laughing baby after a successful operation.

On June 29, TS-Dr. Ton That Minh, deputy director of Thong Nhat Hospital BV Center, said that transplanting ICD for Vinh San, residing in Binh Thanh district was successful.She was cut with an incision (a small incision in the chest skin to put the machine into her body).Vinh San has a twin brother who has the same disease as me, but died in a heart arrhythmia in 2005. His parents are both primary school teachers, difficult economic circumstances, and the cost of buying machines is up to US $ 38,000 (over VND 600 million), helped by Prof. Dr. Bui Van Minh, a cardiologist in the United States.