Following the confirmation that Christian Eriksen suffered a cardiac arrest during the ‘Euro 2020’ match between Denmark and Finland, his national team has announced that the midfielder will be fitted with an implantable cardioverter defibrillator.
The Danish midfielder lost consciousness and crashed on the field, where he was given first aid and resuscitated before being taken to hospital to continue with further diagnosis and treatment.
An implantable cardioverter defibrillator (ICD) is a small device that can treat people with dangerously abnormal heart rhythms.
The ICD sends electrical impulses to regulate abnormal heart rhythms, especially those that can be dangerous and cause a cardiac arrest.
The heart has its own electrical system that regulates the heartbeat. With each heartbeat, there is an electrical signal that travels through the heart, causing it to contract and pump blood. If this does not happen properly, you may have an abnormal heart rhythm (or arrhythmia) and may need an ICD.
How an ICD works
The ICD is placed under the skin, usually in the space just below the clavicle to monitor the heartbeat. Several thin wires connect the ICD to the heart and the heart rate and heart rate are monitored all the time. Cardiac monitoring is performed through electrodes.
If the ICD investigates a dangerous heart rhythm, it can do one or more of the following treatments:
Sets the rhythm – a series of pulses with low electrical voltage at a high rate to correct the heart rhythm.
Cardioversion – one or more small electrical shocks to restore a normal heart rhythm.
Defibrillation – one or more major electric shocks to restore a normal heart rhythm.
How to place an ICD
The implantable cardioverter defibrillator is placed after local anesthesia has been given, but also with sedatives, so you may feel drowsy. The time it takes to place an ICD is from one to three hours. The time required depends on the type of device being placed. Usually the patient has to stay in the hospital overnight, so that the device is checked before you are discharged home.
The ICD is inserted immediately below the clavicle. It resembles a ‘pacemaker’ and is slightly larger than a matchbox.
Implantable cardioverter defibrillator consists of:
Pulse generator – an electronic circuit with batteries.
One or more electrode tubes, which are placed in your heart through a vein.
For some people another type of ICD is appropriate. It is called a subcutaneous ICD – or SICD for short. A SICD works in the same way as an ICD, but is inserted under the skin of the chest (outside the ribs) and has no electrodes placed in the heart.
Who needs an ICD
You may need an ICD if:
You have already had an abnormally life-threatening rhythm and you are in danger of having it again.
You have not had a life-threatening abnormal rhythm, but examinations show that you are at risk for one in the future. This usually occurs from inheriting genes that can cause cardiomyopathy, prolonged QT syndrome, or Brugada syndrome.
You have heart failure and are at risk of developing a life-threatening heart rhythm. This is called cardiac resynchronization therapy with a defibrillator or CRT-D. This device combines a ‘pacemaker’ with an ICD that ensures that the ventricles beat at the right time.
Life with ICD
It is important that the person who has an ICD set up perform regular checks (every up to 12 months depending on the type), so that the device is functional throughout life.
People who have an ICD may be forced to change their lifestyle, for example if they are a driver or involved in sports. Also, some electronic devices, such as transcutaneous electrical devices for nerve stimulation or security systems at airports can affect the ICD.
As for smartphones, care must be taken if they have magnetic material as they can stop the ICD. It is recommended that cell phones be at least 15 inches away from the ICD.
Christian Eriksen is only 29 years old and has many years of career ahead of him, let’s hope that this difficult episode in his life does not force him to give up active football, although health is always in the first place./BW
