Morte cardiaca improvvisa, impiantati per la prima volta in Italia defibrillatori extravascolari di ultima generazione
(Adnkronos) - In Emilia Romagna e Lombardia le prime procedure di Aurora EV-ICD. Biffi (Sant’Orsola), un dispositivo unico nel suo genere con l’elettrocatetere posizionato sotto lo sterno, all’esterno del cuore e delle vene. In grado di erogare una stimolazione rapida per terminare la tachicardia ventricolare o di stimolare il cuore in caso di asistolia, cioè in assenza di battito cardiaco
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00:00 [Music]
00:06 The first facilities were built in 5 big Italian hospitals, one in Emilia-Romagna and four in Lombardy
00:11 with an innovative extravascular defibrillator made in Medtronic, a world-leading company of health care technology
00:19 that in the 1950s invented the technology of the heart pacemaker.
00:23 The new device, called Aurora EVICD, is the result of 10 years of research and marks a step forward in the technology of implantable defibrillators.
00:32 It is in fact unique in its kind, able to provide both life-saving defibrillation and anti-tachycardic therapy and stimulation.
00:39 The system, with a mini-invasive approach under the armpit, with an electro-catheter positioned under the external,
00:45 was designed to avoid long-term complications such as the occlusion of the vessels, infections and risks related to a possible extraction of the electro-catheter.
00:54 92% of patients affected by cardiac arrest die within a few minutes if they are not saved by a defibrillator.
01:00 In the world, many more people die from cardiac arrest than from colon cancer, prostate or pulmonary disease, and the only effective cure is defibrillation.
01:09 The role of implantable defibrillators is to prevent sudden cardiac death or, more simply, sudden death,
01:16 the main cause of death for people under 60, in particular between 30 and 40 years old,
01:21 responsible for 50% of the deaths caused by cardiovascular diseases, for a survival of about 8% of cases without defibrillation.
01:29 And every year in Europe there are about 400,000 cardiac arrests, 60,000 only in Italy.
01:38 Not to be confused with the heart attack or heart attack caused by cardiovascular problems.
01:45 A system applied to this defibrillator is implantable of the latest generation,
01:51 which, based on a clinical study carried out worldwide, has achieved a success rate of defibrillation equal to 98.7%.
01:59 But what is meant a little more specifically by sudden death? And who is affected in particular?
02:07 We asked Mauro Biffi, cardiologist and head of the Operational Unit of Arithmology and Electrophysiology Intervention of the Sant'Ursola Polyclinic in Bologna.
02:17 Sudden cardiac death is a dramatic event that leads to the death of the subject due to rapid ventricular arrhythmia,
02:28 the most frequent of which is ventricular fibrillation or ventricular cardiac attack.
02:34 Other causes of sudden death are not linked to arrhythmias, but are of a different type,
02:39 that is, acute coronary syndromes, acute aortic syndromes, pulmonary embolism.
02:43 We must focus specifically on a sudden arrhythmic death,
02:47 which has a definite probability of being avoided by implantable cardiac devices,
02:53 the so-called implantable defibrillators, which intervene automatically and save the subject's life.
02:59 These defibrillators are dedicated to people who already have a known cardiopathy,
03:04 often they are primitive cardiac diseases of the muscle that evolve over the course of life,
03:11 they are of different types, of different theologies, or even acquired diseases as a result of a damage to my heart,
03:19 produced by a heart attack or a valve disease.
03:21 For a minority of these patients who have clear indications of being vulnerable to rapid arrhythmias,
03:27 I mean ventricular cardiac attack and ventricular fibrillation,
03:30 a device can be implanted that automatically detects the rhythm and ends it,
03:35 putting an end to the potentially lethal situation for the patient.
03:40 But what are the main novelties of this new device?
03:43 This new defibrillator, made available by Medtronic,
03:47 has the feature of having a catheter that detects the signal and delivers the shock
03:54 necessary to end the sudden and rapid arrhythmias outside the heart.
04:00 However, it is in its proximity,
04:04 so it also allows to be able to provide a rapid stimulation to end the ventricular cardiac attack
04:10 or to stimulate the heart in the event of an assistoly, that is, an absence of heart beat,
04:17 in this case by charging the pacemaker function of the heart.
04:21 The technology we have available is a hybrid that combines the best of the first defibrillators,
04:28 which have the catheter inside the heart,
04:30 and that of the subcutaneous defibrillators, which have been available for about 10 years,
04:35 which have the catheter outside the heart and therefore avoid the presence of intracardiac material
04:41 that can cause problems in the long term.
04:44 The extravascular defibrillator, which we have just had available,
04:48 combines the characteristics of both and is small enough to be suitable for small patients.
04:57 It also combines a very rewarding service longevity,
05:05 11 years, which means repeating a simple surgery to replace the exhausted generator only every 11 years.
05:13 This, with the comfort of the person, is very important.
05:16 How do people who are implanted live the use of these devices?
05:20 The psychological concern about being vulnerable to a lethal arrhythmia is lightened.
05:28 Obviously, this extravascular device tends to increase the quality of life for the physical perception of the same.
05:36 Being small, it is not almost felt and therefore the lightening of the thought
05:42 also makes the concept of illness be experienced in a completely different way.
05:47 Also the visibility, being a device hidden from the arm,
05:51 makes no one notice and the subject also lives the illness in a different way.
05:57 [Music]