Recently, a 65-year-old patient suffering from diabetes and chronic kidney disease (CKD) escaped sudden cardiac arrest (SCA) while he was waiting for hemodialysis in a hospital. Fortunately, he was given cardiopulmonary resuscitation (CPR), which saved his life because medical assistance was immediately available. However, the first cardiac arrest made him susceptible to future risk of SCA. The patient was referred to Dr. V. Rajasekhar, MD, DM (Cardiology), Senior Consultant Interventional Cardiology & Electrophysiology, Clinical Director, Yashoda Hi-Tech City, Hyderabad because of his comorbid conditions. Dr. Rajasekhar suggested that the patient considers having a subcutaneous ICD implanted to reduce the risk of SCA.

Globally, heart disease is the leading cause of death for dialysis patients. When the kidney is not functioning well, it cannot efficiently purify the blood, which affects the functioning of the heart in a negative way. Around 700 million people worldwide suffer with CKD. People suffering from this condition require intensive treatment because it is usually fatal. Complications of renal failure can result in infection, anaemia, bone disease, and cardiac problems, the most prevalent of which are heart attacks and heart failure.

Dr. V Rajasekhar said, “the patient experienced heart rhythms that increased his risk of SCA because of his medical history. The patient already had a permcath for dialysis, and despite many attempts to create an AV fistula, there was no vein accessible for dialysis in this case. If the case had not been difficult, a standard ICD would have been advised. As there might be an associated risk of infection with implanting electrode wires in the veins, the patient was identified for a S-ICD implant to eliminate any complications due to intravenous leads.”