ICD & CRT-D Implantation in Ahmedabad Heart Failure & Arrhythmia Devices at Apollo CVHF
Some heart conditions go beyond a slow heartbeat. When the heart is at risk of sudden, life-threatening fast rhythms or when the heart muscle is weak and beating in an uncoordinated way, more advanced devices are needed. The ICD and CRT-D are two of the most important life-saving technologies in modern cardiology.
Dr. Kulin Sheth implants ICDs and CRT-D devices at Apollo CVHF Heart Institute, Bodakdev, Ahmedabad.
ICD Implantable Cardioverter Defibrillator
An ICD is a device designed to protect patients from sudden cardiac death caused by dangerous fast heart rhythms, specifically ventricular tachycardia (VT) and ventricular fibrillation (VF). These arrhythmias can cause the heart to quiver rather than pump effectively, leading to loss of consciousness and death within minutes if not treated.
The ICD continuously monitors the heart rhythm. If a life-threatening rhythm is detected, it delivers a precisely timed electrical shock (defibrillation) to reset the heart back to a normal rhythm. It can also provide pacing for bradycardia (slow heart rate) if needed.
- Who Needs an ICD?
- Patients who have survived a cardiac arrest or an episode of sustained ventricular tachycardia
- Patients with significantly reduced heart function (ejection fraction below 35%) due to heart failure or previous heart attack who are at high risk of sudden cardiac death
- Patients with inherited conditions associated with sudden cardiac death, such as hypertrophic cardiomyopathy, long QT syndrome, or Brugada syndrome
- Patients with a prior history of serious ventricular arrhythmia
CRT-D: Cardiac Resynchronisation Therapy Defibrillator
In heart failure, the left and right ventricles often lose their normal synchrony; they stop contracting in a coordinated way, which further reduces the heart’s pumping efficiency. This dyssynchrony is often visible on an ECG as a bundle branch block pattern.
A CRT-D device uses three leads one in the right atrium, one in the right ventricle, and one in the left ventricle to deliver coordinated electrical impulses that resynchronise the contractions of both ventricles. This dramatically improves the heart’s pumping efficiency and is one of the most effective treatments available for appropriately selected heart failure patients.
The defibrillator component of the CRT-D simultaneously protects against life-threatening ventricular arrhythmias.
- Who Needs a CRT-D?
- Patients with heart failure and a significantly reduced ejection fraction (below 35%)
- Patients with a wide QRS complex on ECG indicating electrical dyssynchrony between the ventricles (typically a left bundle branch block)
- Patients who remain symptomatic despite optimal medical therapy for heart failure
- Patients who also require protection from sudden cardiac death (combined CRT-D rather than CRT-P)
What to Expect: The Procedure
ICD and CRT-D implantation is performed under local anaesthesia with sedation. The procedure is similar to pacemaker implantation: leads are guided through a vein into the heart, and the device generator is placed in a small pocket beneath the skin below the collarbone.
CRT-D implantation is technically more complex than a standard pacemaker or ICD, as the left ventricular lead must be positioned precisely in a branch of the coronary sinus. The procedure typically takes 90 minutes to 3 hours, depending on anatomy and complexity. Hospital stay is usually 2 to 3 days.
Location: Where Are ICD and CRT-D Devices Implanted?
Apollo CVHF Heart Institute
- +91 7096 800 800
- Pakwan Cross Road, Sarkhej - Gandhinagar Hwy, opp. GNFC Tower, next to l.O.C petrol pump, Bodakdev, Ahmedabad, Gujarat 380059
- Angiography, Angioplasty, Pacemakers & Devices (ICD, CRT-D), Structural Heart Procedures (ASD/VSD/PDA Closure, TAVI), Complex Coronary Work (LMCA, Bifurcations, IVL, Rotablation)
- Open 24 hours
Dr. Kulin Sheth's Approach
Dr. Sheth is known for a calm, thorough, and patient-centred consultation style. He takes time to listen, never rushes through an appointment, and explains findings clearly so that patients leave with a genuine understanding of their heart health and what needs to be done, if anything.
Patients also appreciate that Dr. Sheth only recommends investigations that are genuinely needed. There are no unnecessary tests, no unnecessary procedures, and no unnecessary alarm.
Advanced Devices. Expert Hands. Life Protected.
FAQs
An Implantable Cardioverter-Defibrillator (ICD) is primarily designed to monitor heart rhythms and deliver a life-saving electrical shock if it detects lethal tachyarrhythmias, such as ventricular tachycardia or ventricular fibrillation. A Cardiac Resynchronization Therapy Defibrillator (CRT-D) combines the shock capabilities of an ICD with biventricular pacing. Dr. Kulin Sheth recommends a CRT-D specifically for patients with advanced heart failure and ventricular dyssynchrony (delayed electrical conduction), as it synchronizes the pumping action of both the left and right ventricles to maximize cardiac output.
The implantation is a specialized, minimally invasive procedure performed in a cardiac catheterization laboratory under local anesthesia and conscious sedation. Dr. Kulin Sheth makes a small surgical incision below the collarbone to create a subcutaneous pocket for the device generator. Guided by real-time fluoroscopy, the insulated pacing/defibrillator leads are advanced through a vein into specific chambers of the heart. For a CRT-D, an additional third lead is precisely positioned via the coronary sinus to pace the left ventricle. The procedure typically takes between two to three hours.
Dr. Kulin Sheth recommends these advanced cardiac devices for the primary or secondary prevention of sudden cardiac death. Key clinical indications include:
Severe Heart Failure: Patients with a significantly reduced left ventricular Ejection Fraction (EF less than or equal to 35%) despite optimal medical therapy.
Prior Cardiac Arrest: Survivors of sudden cardiac arrest or documented sustained ventricular arrhythmias.
Ischemic or Non-Ischemic Cardiomyopathy: Structural heart disease resulting from past heart attacks or genetic conditions that drastically increase arrhythmia risks.
Patients generally require a 24 to 48-hour hospital stay for continuous telemetry monitoring, device interrogation, and post-operative optimization. Dr. Kulin Sheth advises avoiding heavy lifting and limiting overhead arm movements on the side of the implant for four to six weeks to ensure the leads firmly endothelialize (secure themselves) within the heart tissue. Regular remote or in-clinic device checks are scheduled at Sheth Heart Clinic in Ahmedabad every three to six months to monitor battery longevity, lead integrity, and stored arrhythmic data.
Yes, most modern ICD and CRT-D systems implanted by Dr. Kulin Sheth are MRI-conditional. This means patients can safely undergo Magnetic Resonance Imaging (MRI) scans provided specific safety protocols are met. Prior to the scan, the device must be evaluated and temporarily programmed into a dedicated “MRI mode” to prevent accidental shocks or pacing inhibition. Immediately following the completion of the scan, the device is reprogrammed back to its original therapeutic settings.