Innovations in ICD Technology Reduce Risks for Patients

By Naushad A. Shaik, MD

Determining treatment options for patients suffering from cardiac conditions is rarely a simple process. Physicians are daunted by devices and recommendations that weigh clinical benefits and risk—often one benefit at the expense of another. Single- versus dual-chamber implantable cardioverter devices (ICDs) are a clear illustration of this dilemma.

Is a dual-chamber ICD worth the risk? For patients who have demonstrated pacing indications, dual-chamber ICDs are often selected as the best choice. However, it’s a choice that comes with risk—risk of implantation challenges, lead complication, and mortality. New data also demonstrates no significant increase in survival rates.

Other studies have shown that single-lead ICDs have fewer risks for patients but leave them open to inappropriate shocks without the dual-chamber sensing capabilities.

Determining the best approach for each patient is a complex process that reviews the risk versus benefit. This is a dynamic process that evolves with the advancements of medical device technology.

Recent innovations in ICD technology have presented a new option that provides high-fidelity atrial signals with a single lead—a single-lead ICD with dual-chamber technology. This new technology is designed to obtain the atrial signal (P waves) utilizing a ventricular lead with a pair of sensors (dipoles) in the right atrium. In essence, this technology provides the most information (atrial signal) with the least amount of hardware (leads)—reducing patient risk.

Each patient is unique. Treatment and device decisions will always involve some gray area. But it is clear that as more technologies and innovations surface for cardiovascular devices, patients will reap the benefits. Having more options that include less hardware but better diagnostic information will allow physicians to improve the quality of patient care and ultimately ensure a better quality of life for patients.

Naushad A. Shaik, MD, specializes in cardiovascular electrophysiology. Shaik has a special interest in complex ablations, implantable cardiac devices, and EP focused research. He is a partner with Cardiovascular Associates Inc., a private practice cardiology group that has been established in the Central Florida area for the last 30 years. He is on staff at the Florida and HCA hospital systems in Orlando and Kissimmee, FL.

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