Implant of Biventricular Implantable Cardioverter ...



Implant of Biventricular Implantable Cardioverter Defibrillator also known as cardiac resynchronization therapy defibrillator (CRT D)

Explanation of procedure

The aim of the biventricular implantable cardioverter defibrillator CRT-D is to treat support your weak heart muscle by restoring helping the heart's pumping co-ordination and to look for, monitor identify and, if required, treat any life-threatening heart rhythms. They CRT-D devices can provide a range of treatments to correct abnormal heart rhythms including electrical pacing for fast and slow electrical pacing heart rhythms and high energy defibrillatorion shocks. The implant procedure involves inserting 3 wire(s)remove brackets as we know they will have 3! (also called leads) into your heart through a vein just under your collar bone. This is done with the help of X rays. The wire(s) are then connected to the biventricular cardioverter defibrillator CRT-D battery box. An incision is made (usually just below the collar bone, near where the vein that the wires are inserted into) and a space is formed just below the skin to make a `pocket’. The box is put into a pocket made under your skin in the same area. The placed into the pocket, which is then closed using surgical stitches. The doctor may test the cardioverter defibrillator part of the device during the procedure to ensure it is working correctly. This involves the delivery of 1 or more high energy shocks while you are sedated.

The intended benefits of this procedure

To treat symptoms associated with your weak heart muscle so that you can do more and experience fewer symptoms.

To look for and treat any abnormal fast and/or slow heart rhythms should they occur.

Serious or frequently occurring risks:

Less than 1 in 100 risk of serious or life threatening complications such as:

▪ blood clots which could cause a stroke or heart attack;

▪ puncture of the blood vessels or heart wall which could lead to a collection of blood in the sac surrounding the heart and which could require an emergency operation to repair.

2 in 100 risk of bleeding or bruising around the wound site which may require a tight bandage overnight to control, removal of blood clots from around the box or removal of the entire system. This risk is increased if you are taking blood thinners thinning medication.

2 in 100 risk of infection in or around the wound.

0-5 in 100 risk of a collapsed lung during the procedure.

10-15 in 100 risk of being unable to place a wire securely on the left side of the heart. This may require a further surgical operation at a later date.

5-10 in 100 risk of the wire(s) moving out of position requiring a further procedure to re-position the wire(s) at a later date.

30:100 patients may experience no improvement in their symptoms of heart failure.

Any extra Additional procedures which may become necessary during or after the procedure

Cardioversion or defibrillation. An electrical shock across the chest wall to restore a normal heart rhythm.

I have discussed what the procedure is likely to involve, the benefits and risks of any available alternative treatments (including no treatment) and any particular concerns of this patient.

□ Biventricular implantable cardioverter defibrillator (CRT D) patient information leaflet and a wound care advice sheet have been given to you.

The procedure will involve:

□ General anaesthesia □ Local anaesthesia □ Sedation

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