A University of Nebraska Medical Center physician has performed the first implant in Nebraska of an implantable cardioverter defibrillator (ICD) using a new connector system that minimizes the number of connections between cardiac leads and the ICD.
The procedure was performed July 30 at the VA Nebraska-Western Iowa Health Care System’s Omaha Medical Center by John Scherschel, M.D., assistant professor in the UNMC Department of Internal Medicine, section of cardiology. The patient, Eddie Fidler, a 75-year-old man from Clarinda, Iowa, is out of the hospital and has returned to his normal activity level. He is pastor of the Church of God in Clarinda.
Dr. Scherschel, a cardiac electrophysiologist, joined the UNMC faculty on July 1 after completing a fellowship in clinical cardiac electrophysiology at the Krannert Institute of Cardiology at Indiana University School of Medicine.
The new connector system, called SJ4, is manufactured by St. Jude Medical in St. Paul, Minn. It was approved by the Food and Drug Administration in April and first implanted in a patient in early June. It has only been available for use at a limited number of medical centers around the country.
The SJ4 features a single connection between the device and the defibrillation lead, and a single set screw. Previous defibrillator lead designs required three separate connections and four set screws.
With fewer connections to make, the SJ4 reduces the time it takes to implant the AICD and thus reduces the risk of infections and incorrect connections, Dr. Scherschel said.
“It’s a significant breakthrough in the electrophysiology field,” Dr. Scherschel said. “The simpler the device, the lower the risk of complication or failure. Patients are the real benefactors of this new technology. It certainly has the potential to improve the implant procedure, because it reduces the volume of device in the chest wall and that should help add to the patient’s comfort level.”
Another major benefit to patients, Dr. Scherschel said, is that the lead and ICD are part of a system which allows patients to be monitored remotely.
St. Jude Medical has a long history of working with the VA Nebraska-Western Iowa Health Care System, Dr. Scherschel said, so that’s why it was selected to the first site in Nebraska and the first VA medical center in the country to use this exclusive technology.
If patients express a preference for the SJ4 device or if there is a medical need for it, Dr. Scherschel said he would be able to use the device for future procedures performed at The Nebraska Medical Center, UNMC’s hospital partner.
What is an ICD?
An implantable cardioverter defibrillator (ICD) is a device that is implanted in the chest to monitor for and, if necessary, correct episodes of rapid heartbeat. If the heartbeat gets too fast, the ICD will stimulate the heart to restore a normal rhythm. In cases where the heartbeat is so rapid that the person may die, the ICD will give an electric shock (defibrillation) to reset the heartbeat.
An ICD is similar to a pacemaker, which is another type of device that corrects an abnormal heart rhythm. Pacemakers are usually chosen to correct a heart rhythm that is too slow, while ICDs are used to correct a heart rhythm that is too fast.
The ICD is implanted into the patient’s chest during a minor surgical procedure. A short stay in the hospital is usually required. Some patients may need to take antiarrhythmic medications that help the heart maintain a normal rhythm.
Once the ICD is in place, it runs on batteries for about four to seven years, depending on how often an electric shock is discharged. ICD batteries will not run out unexpectedly, as physicians can detect when the battery is running low during a routine office visit.
People with ICDs need to be careful in certain situations. More information on living with an ICD can be found by clicking on the following link: http://www.sjm.com/procedures/procedure.aspx?name=ICD+Implantation§ion=ExpectAfter.
It is estimated that about 400 people per million have ICDs in the United States.
The VA Nebraska-Western Iowa Health Care System proudly serves more than 167,660 veterans in Nebraska, western Iowa and portions of Kansas and Missouri. Omaha’s medical center is an inpatient facility and also a large outpatient clinic for primary and specialty care. The Community Living Center is in Grand Island. There are community-based outpatient clinics in Lincoln, Grand Island, North Platte, Holdrege, Norfolk, Bellevue and Shenandoah, Iowa. For more information, visit http://www.nebraska.va.gov.
UNMC is the only public health science center in the state. Its educational programs are responsible for training more health professionals practicing in Nebraska than any other institution. Through their commitment to education, research, patient care and outreach, UNMC and its hospital partner, The Nebraska Medical Center, have established themselves as one of the country’s leading centers in cancer, transplantation biology, bioterrorism preparedness, neurodegenerative diseases, cardiovascular diseases, genetics, biomedical technology and ophthalmology. UNMC’s research funding from external sources now exceeds $100 million annually and has resulted in the creation of more than 3,200 highly skilled jobs in the state. UNMC’s physician practice group, UNMC Physicians, includes 513 physicians in 50 specialties and subspecialties who practice primarily in The Nebraska Medical Center. For more information, go to UNMC’s Web site at www.unmc.edu.