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With more and more people eligible for implantable cardiac defibrillators (ICD) as a result of a new ruling from Medicare, cardiologists at the Jefferson Heart Institute want people to be aware of why and how the devices work.

An ICD is a small electronic device that is implanted under the skin in the upper chest of a heart patient, usually in a hospital setting while the patient is relaxed in a state known as conscious sedation.  In addition to monitoring the person’s heart rhythm, an ICD can prevent sudden death from cardiac arrest due to life-threatening abnormally fast heart rhythms.

The recent Medicare decision expands reimbursement for the device to cover what is known as primary prevention. It came as a result of data from a study called the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) that determined the devices could help prevent death in persons with moderate heart failure.

“Previously, ICDs were primarily used for people who had already suffered cardiac arrest,” says Arnold Greenspon, M.D., director of the Cardiac Electrophysiology Laboratory at Thomas Jefferson University Hospital, Philadelphia. “Now, we will be implanting the devices in people who have had a heart attack or another reason for a decrease in the pumping function of their heart. They have not yet had a serious heart rhythm problem. But, nonetheless, they are at high risk for sudden cardiac death.”

These devices will monitor a person’s heart rhythm and provide a shock if the rhythm suddenly becomes rapid.

“The momentary shock feels different to each individual,” explains Dr. Greenspon, who is also clinical professor of Medicine at Jefferson Medical College of Thomas Jefferson University. “Some people say that they feel a sudden jolt in their chest while others are hardly aware of the experience. All wearers say that they feel normal in a few minutes. After the first shock—however it feels to the patient—wearers are encouraged to call their cardiologist. The physician will likely encourage the patient to come in for a check-up just to make sure that everything is okay.

“If the patient begins to be shocked regularly, the cardiologist may also prescribe medication to be taken on an ongoing basis,” Dr. Greenspon says. “Hopefully, the expanded indication for this device can save lives.”

A patient who comes to the Jefferson Heart Institute with a problem, Dr. Greenspon says, will be evaluated by a team of specialists and be presented with a therapy that is tailored to her or his condition. Together the team, along with members of the Advanced Heart Failure and Cardiac Transplant Center at the Jefferson Heart Institute, offers a very patient-centered environment that includes a wide range of specialty treatment and testing.

To make an appointment with the physicians at the Jefferson Heart Institute call 1-800-JEFF-NOW.