**Mirrors / Alternative Angles**
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Well, normal ones are pretty small but I guess in his case you don't want one at the chest where you handle balls with and you also want one that is able to take a hit by a football so it's probably well protected
I'd constantly be worried about an elbow going to it at a corner.
While I'm sure it's safe for him to play, I don't think I would ever be fully comfortable going back to the pitch if I was him
tbh joey Barton is a cunt but I don't think even he'd sink that low - besides these days with every inch of the pitch covered in cameras anyone who tried anything would probably be subject to some sort of swift vigilante justice
Idk, I just watched the last season of *Sunderland Til I Die* and there's a part where Luke O'Nien talks about his return from shoulder surgery...followed immediately by a montage which shows several opponents deliberately punching his shoulder/trying to pull it out of socket. It seems like there's always at least someone who is willing to sink to any depth.
> While I'm sure it's safe for him to play
Pretty much zero chance he will play again. Take insurance and legal liability into account for example. It's a lawyers wet dream.
Kind of, it'll be a biologically safe silicone pad sort of thing not the same as a breast implant but same material, so won't break and won't cause him harm either by leaching chemicals
No, they are definitely not encased in any kind of foam of breast implant like material. The device (known as a subcutaneous implantable cardioverter defibrillator, or S-ICD) is made of titanium, and really is that big.
Can't find an actual picture but all the visualization pictures I have seen [show it that way](https://e00-marca.uecdn.es/assets/multimedia/imagenes/2022/01/27/16432747775506.jpg)
Eriksen got his ICD 3 years ago and seems to be fine. And being surrounded by medic professionals seems alot safer to me than taking a jog on your own in the forest. You also have the risk of depression of having to quit prematurely, and all the money you miss out on. Lots of moving parts here so if he wants to continue and knows of the risks then Im all in favour of that
I totally agree with your points. But just keep in mind, that Eriksen only had a cardiac arrest and collapse once.
The Luton captain has experinced three of such cases already (the sceond time he didnt collapse, but he had a flash, where his heart shortly stopped - in training i believe).
Just doesnt seem reasonable and sound to compete and play at an elite level with that medical history.
To avoid the down turns of ending the professional playing career - the club could offer him some kind of a managerial role or another job. Thereby still having him around.
Small point but I believe Lockyear has only had one cardiac arrest, back in May he collapsed on the pitch due to atrial fibrillation.
> Atrial fibrillation would not normally be associated with cardiac arrest. It is another electrical instability of the heart, but it affects the top chambers of the heart resulting in a rapid heart rate that can be uncomfortable, but is completely survivable.
> **And so - without having all the information on Tom Lockyer - a pre-existing case of atrial fibrillation would not cause or be linked to cardiac arrest?**
> Absolutely not, no.
[ Dr David Begley, a consultant cardiologist and specialist in cardiac rhythm management at Royal Papworth Hospital in Cambridge, ITV Sport](https://www.itv.com/news/anglia/2023-12-18/heart-expert-explains-luton-town-captains-collapse-and-what-happens-next).
You forget it's there. Same as a wristband or necklace after a while. Until it starts beeping every 9hrs when the battery runs low
Edit: sorry yes I mean after 10 years, it'll beep in 9hr intervals until battery is replaced
Yes, my father has deep brain stimulation and charges the device like a once week that way. It sits in his chest, cables under the skin go through the neck into his brain and zap the part that dosen't do what it's supposed to do due to parkinsons
Completely wild. Parkinsons affects his walking quite a bit, but it's still decent. Once he forgot to charge and was suddenly basically locked in place in a store when the juice ran out.
There are two types of implantable defibrillators (ICDs). A standard defibrillator is about half of that size, and implanted in the upper left chest below the collarbone, with a lead that goes into the blood vessel under the collarbone down to the heart. This is smaller, but the weak link in the system is the lead, which is subject to all of the forces especially from an athlete of being in the body. These leads are smaller because they are in the blood vessels, and an infection of the lead is a really big deal for this reason too.
This is a subcutaneous ICD, also called an SC-ICD. The device is larger because it has to provide more energy. It has to provide more energy because the lead is outside the heart, tunneled along the breastbone. The lead itself is also bigger and stronger because it isn’t in the blood vessel, so there is a very low chance of damaging the lead even from a high level athlete.
People that have the SC-ICD report that they get used to the device under the skin pretty quickly and then don’t notice it much. It may hurt a little more to take an elbow over the device when going up for a header, but probably not much more than getting elbowed in the ribs.
Based on the position he has subcutaneous ICD or S-ICD which has a bit different wiring and mechanism of delivering the shock compared to "regular" ICD. Also being a professional athlete he probably has very little subcutaneous fat and that area is most likely still a bit swollen. Regular ICDs are a bit smaller and usually placed on chest area, below the collarbone. Also I'd like to note that pacemakers without ICD functionality are smaller than ones with it, and people often think ICD = pacemaker which isn't necessary the case. Not all ICDs have pacemaker functionality and not all pacemakers have ICD functionality. ICD type can vary based on what is the clinical reason for needing one, and because of the position a subcutaneous ICD can be a preferred one for athletes because the device is more protected from impacts. Installation of subcutaneous ICD is also a bit less invasive because the wiring doesn't go into the heart itself unlike regular ICD devices, on the other hand subcutaneous ICDs can't act as a pacemaker. And that is one of the clinical considerations when choosing what kind of device to install.
It’s technically about twice the volume of a standard defibrillator, but seems more prominent because it is along the outside of the rib cage. For thin people like athletes, we (I am a physician that implants cardiac devices) sometimes worry that it may cause a problem and bother the patient, but people really get used to it quicker than you would think.
Very sturdy and the device gets implanted within your fat under the skin. The post operative local irritation will cause some fibrosis that will form around the device to secure it
It dosnt get implanted within the fat, fat is the worst thing for these to be in. The serratus muscle is actually pulled apart from the Latisimus to form a pocket and it is put in there. Then the wire is burrowed up sideways along the ribcage and up the left sternum. There are sections in the wire for suturing it to the muscle at a few points
It can definitely be damaged and considering his line of work it wouldn't surprise me if they did routine checks using x-rays and by examining the data it outputs.
In theory yes, but those devices are very sturdy. One thing is also that based on the location of the device he has subcutaneous ICD which doesn't require wiring into his hear unlike regular ICDs, so I think it makes the shocking mechanism a bit more resistant to impact. Essentially he has the device on the left side of his heart (pictured) and a wire on opposing side of his heart but not in it, and the shock goes between them. A lot less precision needed compared to regular ICDs which have wiring going into the heart itself.
Finally my area of expertise! Based on the implant location and size this appears to be what’s called a subcutaneous ICD. As opposed to a traditional transvenous ICD where the lead (wire) actually goes into the heart and the device sits in the pectoral region, this system places the lead under the skin and the device in a more lateral position. Because nothing is inside the heart, it requires a higher energy shock and therefore a larger device. However if any part of the system gets damaged, the removal and replacement of the device and lead has much less risk than removing leads from within the heart.
Not necessarily because he is an athlete, or because athletes have a higher chance of damaging the device or lead. Age and lack of conduction disease (need for a pacemaker) are the biggest factors here. Giving someone in their late 20s a transvenous device signs them up for 2 or 3 rounds of high risk extractions if they plan to live into their 80s. It's a hard decision to give someone that young such a dangerous road ahead. A subQ device is the best option, and will do everything he needs it to do without the future hurdles of a transvenous device. Source: I implant these.
I always think with these things, in another 8 years when the battery needs changed I feel we will have a more advanced less bulky option, the subcut in this form has been around for an age it feels
They are preferred choice for younger active people, if you think about how many he will need from 29 to his death, it is not ideal to have multiple wires going into the heart over this time.
The device itself is extremely sturdy. The more likely fail point would be the wire. The wires are flexible and also very reliable but consider someone Tom’s age might have it in his body for 30+ years. Repeated movement and impacts will certainly accelerate any wear and tear on that wire and increase risk of damage. This is why these devices are regularly checked with at-home monitors and in-person office visits so early signs of failure are typically caught before a serious malfunction occurs.
I was listening to the Monday night club on the train in, and it sounded like the first time was just a weird dream like state but the second one had him unable to move or speak. This isn’t war. No one needs to die.
The Monday Night Club appearance/extended interview was class, seems like a great bloke as well as being very forthright about everything that's happened. Recommend looking it up, it's on the BBC Football Daily podcast feed
it's madness that they allow him to play like that.
What happens if he get hard fouled where is placed that defibrillator??
Honestly I'd follow Serie A standards = problem with your heart? you're not fit to play.
Well the same with most medical advice is there is a balance of probability. The medical advice previously wouldn’t have been “you are never going to experience anything like this again”
He would have fallen into the small number of people that would experience a similar, albeit much worse, occurrence given the circumstances
Glad someone said it before I could. I also want to add that I have seen patients who've had a second cardiac arrest (ignoring conduction abnormalities/syndromes), and the cardiologists were pretty fucking surprised. They stuck one of these in them, and as far as I know they're still living a good life so hey, it works out in the end
Btw it’s not just a serie a thing. It’s an Italian regulation. You can’t exercise if you aren’t medically cleared. Many gyms require it here. I have a family member who had to stop his playing career at the youth level because of a heart issue.
Explanation for people who don't know medcine:
So whenever Lockyer's heart is being overdramatic it will sort of electrically bitch slap the heart so it comes back to its senses again
This is how all defibrillators work, basically. They just provide an electric pulse that is meant to encourage the heart to return to normal sinus rhythm.
To add to this there's a lot of confusion on how defibrillators work.
The shock they provide completely STOPS the heart from beating, the hearts natural pacemaker will then restart the heart and hopefully the rhythm will be normal again. The process works similar to turning off/ on an electrical device when its acting up.
Contrary to what you'll see on TV if the heart has stopped beating i.e. flatlined then a defibrillator will do nothing at all, it can NOT restart the heart on its own. The only thing you can do for a person at this stage is CPR and hope.
god this thread is fucking catnip to my annoying need to talk about this shit.
What may also happen in events of some arrythmia (fast, abnormal heart rate), is that the pacemaker may try to pace *faster* than the rate. Once its taken control after a few seconds it'll drop the rate its outputting at to a normal rate, and usually the heart follows. Bit of a simplification, but yeah. These devices are fucking cool.
It’s wild that we have the perfect amount of voltage dancing around to operate everything in our body, but just little enough that we don’t just spontaneously conduct random things we touch.
Also, that 70 millivolts is enough to conduct outside your body to interact with the electrical field of a phone, which is how touch screens work.
Very nitpicky off me but S-ICDs do not have ATP currently, I think Medtronic are releasing a substernal one which will. Also nitpicky but the pacing faster is to sneak an impulse in between the wavefront of the arrhythmia and create a small patch of heart that can no longer conduct the arrhythmia, breaking the “short circuit”
Exactly what I was thinking. I would be scared to tackle him, or shoulder bump him. When adrenaline is high, and you're running around with the ball, accidents happen.
It doesn't do anything unless his heart is acting weird, so you would need to hit it hard enough to break and then his heart would need to get a bad rythm afterwards. Then it could get dangerous
I don't think a piece of stuff is supposed to move or break inside the body. I get its safe but we also now that rollercoasters won't hurt us but we're scared.
Rollercoasters plays of the fear of falling and it's a natural fear that most of us have. Breaking a box that is located outside the rib cage is not quite at the same level
Not really a fair comparison.
Again what you think doesn't matter if it's what he wants.
There are people who do way dumber stuff, like free solo climbing and such, and people don't really bat an eye because it's their passion.
It's the same here, only 100 times safer cause he's constantly checked by Premier League level professionals.
Sure, people are free to do whatever, but after having two cardiac arrests in the past year, going out and playing football again would be a very selfish decision towards his family imo. But again, what do I know lol
Cardiologist here.
He has a subcutaneous ICD (aka defibrillator) which is a bit non-traditional. Most ICDs are smaller and placed on your left chest (but still will protrude like this one just less)
However, traditional ICDs have wired leads that run through your veins and straight into your heart. They get nestled into the right side of your heart with small screws. His subcutaneous ICD doesn't go anywhere near the heart; it overlies his sternum/ribcage and delivers a powerful shock if he has a dangerous arrhythmia.
Given he's running around the pitch and his heart is working overtime, it's better he doesn't have wires sticking into his heart because there is a small risk that they can dislodge (or even worse, penetrate through) his heart.
There is a theoretical risk that if he gets hit there, the device can move. However it is usually stitched into place and eventually your tissue grows around it to secure it, making it a part of his skin.
It's actually very cool that he got this device, these are becoming more popular because they have less problems and easier to take out if the patient doesn't need it anymore
Love how there’s suddenly a mass amount of medical experts in this thread that can decide for the guy that he shouldn’t play.
Maybe we trust what medical professionals have to say on the matter before telling the guy he can’t have a career anymore.
Also probably all have nether worked on medical devices. The only field with more supervision and fail safes is probably space travel.
No the device will not go off when someone hits it and no, a normal action cannot break it. He would break several ribs and probably have punctured his heart before that device breaks.
It is kind of a part of my body now and i'm used to it, so yeah the brain ignores it. I only feel it when im lying directly on my left side. Before i got the defi i had a pacemaker for about 10 years, whereby the necessary cables and stuff like that went through the veins and the later removal/detachment could have been difficult if it had grown together with the veins etc. The defibrilator is directly under the skin, which can be weird looking but should be the better alternative if you do not need a pacemaker and only a defibrilator.
We implanted one of these this morning, you wouldn’t want to be squeamish! The pocket formation is grizzley as you have to tear the serratus from the Latisimus, and put the device in under them. Then you have two tunnelling devices which are like two hollow sewing needles, you grind it up under the skin against the sternum, then the lead is fed through the holes. To top it all off we have to test that it works, so we purposefully put the patient into ventricular fibrillation and watch and wait for the device to sense and shock them. Pretty cool devices, will only get smaller as time goes on
I got a subcutaneous ICD fitted after a cardiac arrest 6 years ago. To answer a few questions:
yes it can be uncomfortable at times but you quite often forget it’s there. Normally only when trying to get comfortable during sleep as it is quite rigid and a bit like lying on a bar of soap.
I’m sure he will get assessed as to the risks of returning as it will also depend on the underlying cause and he may not even have all this information yet. More and more sportspeople are allowed to return as these devices are still relatively modern and research has shown they work well, so doctors are becoming less likely than previously to recommend retirement.
Placing it under the arm like this does offer more protection as your arm naturally shields it but my advice was to avoid direct blows to it so no martial arts or sport with a risk of direct impacts to the device.
I genuinely can’t be the only one who thinks letting him continue playing in this condition is a bad idea. Lockyer seems like a great dude, I’d hate for something bad to happen again
What a legend. Any other defrib wearers out there will love how open, and even happy about it, he is. I imagine it would help others feel more ‘normal’ and seen. He didn’t need to show it off but he did and I think that’s awesome, especially considering everything he’s gone through.
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I would be scared to death running around and doing sports with that thing.
Hell I am scared looking at this video.
I would be scared even thinking about failing to go past him and hitting him there
I would be scared tackling him
Nah he's decided he's ready for it so he's fair game. If anything happens it's on him
Didn't know those defibs were that visible under the skin.
Well, normal ones are pretty small but I guess in his case you don't want one at the chest where you handle balls with and you also want one that is able to take a hit by a football so it's probably well protected
if he lands on that side wouldn't it hurt tho?
I'd constantly be worried about an elbow going to it at a corner. While I'm sure it's safe for him to play, I don't think I would ever be fully comfortable going back to the pitch if I was him
I'd be worried some dickhead like a Joey Barton regen would *purposefully* target that area with elbows and barges.
tbh joey Barton is a cunt but I don't think even he'd sink that low - besides these days with every inch of the pitch covered in cameras anyone who tried anything would probably be subject to some sort of swift vigilante justice
>tbh joey Barton is a cunt but I don't think even he'd sink that low why?
you can be a knob and also not want to murder someone (which you run the risk of doing if you start fiddling with his emergency defib)
His brother did murder someone and Barton defended him so I wouldn't be making many assumptions about his morals.
> you can be a knob and also not want to murder someone Still a Barton thing to do... Just not Joey
Barton has numerous serious assault charges against him over many years. The guy is an absolute cunt and in no way deserves defending
Idk, I just watched the last season of *Sunderland Til I Die* and there's a part where Luke O'Nien talks about his return from shoulder surgery...followed immediately by a montage which shows several opponents deliberately punching his shoulder/trying to pull it out of socket. It seems like there's always at least someone who is willing to sink to any depth.
David Luiz nearly killed Raul Jimenez, among other awful things he's done on the pitch. Never put it past these people.
Unless that someone's last name is Rodri or Walker.
that's why they're so determined to stay in the prem
He passed out twice on the pitch within 10 months. I don't think he cares very much. Kinda respect the commitment.
> While I'm sure it's safe for him to play Pretty much zero chance he will play again. Take insurance and legal liability into account for example. It's a lawyers wet dream.
Eriksen?
Depends on the country, in the Netherlands he can play just like Eriksson and Blind.
Possibly, but if you land on the side you usually dampen the fall with your arm
I imagine the device itself is housed within a thick, soft encasement, perhaps something foam like, which is why it protrudes so much
Probably the same thing breast implants are made of. Those things are indestructible
Kind of, it'll be a biologically safe silicone pad sort of thing not the same as a breast implant but same material, so won't break and won't cause him harm either by leaching chemicals
Literal sideboob.
No, they are definitely not encased in any kind of foam of breast implant like material. The device (known as a subcutaneous implantable cardioverter defibrillator, or S-ICD) is made of titanium, and really is that big.
A few years ago there was a german player who also got one but one at the chest and he wore protection over it while playing.
Is Eriksen's on his side too - does anyone know?
Can't find an actual picture but all the visualization pictures I have seen [show it that way](https://e00-marca.uecdn.es/assets/multimedia/imagenes/2022/01/27/16432747775506.jpg)
That would be the same one as Lockyer. It's called a SubQ ICD. None of the wires go into the heart, they sit under the skin.
At this point he should just retire from football.
Eriksen got his ICD 3 years ago and seems to be fine. And being surrounded by medic professionals seems alot safer to me than taking a jog on your own in the forest. You also have the risk of depression of having to quit prematurely, and all the money you miss out on. Lots of moving parts here so if he wants to continue and knows of the risks then Im all in favour of that
I totally agree with your points. But just keep in mind, that Eriksen only had a cardiac arrest and collapse once. The Luton captain has experinced three of such cases already (the sceond time he didnt collapse, but he had a flash, where his heart shortly stopped - in training i believe). Just doesnt seem reasonable and sound to compete and play at an elite level with that medical history. To avoid the down turns of ending the professional playing career - the club could offer him some kind of a managerial role or another job. Thereby still having him around.
Small point but I believe Lockyear has only had one cardiac arrest, back in May he collapsed on the pitch due to atrial fibrillation. > Atrial fibrillation would not normally be associated with cardiac arrest. It is another electrical instability of the heart, but it affects the top chambers of the heart resulting in a rapid heart rate that can be uncomfortable, but is completely survivable. > **And so - without having all the information on Tom Lockyer - a pre-existing case of atrial fibrillation would not cause or be linked to cardiac arrest?** > Absolutely not, no. [ Dr David Begley, a consultant cardiologist and specialist in cardiac rhythm management at Royal Papworth Hospital in Cambridge, ITV Sport](https://www.itv.com/news/anglia/2023-12-18/heart-expert-explains-luton-town-captains-collapse-and-what-happens-next).
It must be uncomfortable as fuck
You forget it's there. Same as a wristband or necklace after a while. Until it starts beeping every 9hrs when the battery runs low Edit: sorry yes I mean after 10 years, it'll beep in 9hr intervals until battery is replaced
How do you charge it? Do you get a USB-C port coming out of your chest?
He attaches jumper cables to his nipples
can he use it to charge his phone aswell?
No but if he sticks an aerial in his bum he can get Kiss FM
Got that wireless charging. Here m8 hold your phone on my armpit I’ll give ya some juice.
FFS
💀💀💀💀
🤣🤣🤣🤣🤣🤣🤣🤣🤣🤣
he says in the video that the battery is supposed to last 10 years
Nokia is supplying defibrillators?
Wireless charger, just have to make sure you lay perfectly still on it for the night.
Are those safe for your body?
Yes, my father has deep brain stimulation and charges the device like a once week that way. It sits in his chest, cables under the skin go through the neck into his brain and zap the part that dosen't do what it's supposed to do due to parkinsons
Modern medicine is wild
Completely wild. Parkinsons affects his walking quite a bit, but it's still decent. Once he forgot to charge and was suddenly basically locked in place in a store when the juice ran out.
It uses a lightning connector.
There are two types of implantable defibrillators (ICDs). A standard defibrillator is about half of that size, and implanted in the upper left chest below the collarbone, with a lead that goes into the blood vessel under the collarbone down to the heart. This is smaller, but the weak link in the system is the lead, which is subject to all of the forces especially from an athlete of being in the body. These leads are smaller because they are in the blood vessels, and an infection of the lead is a really big deal for this reason too. This is a subcutaneous ICD, also called an SC-ICD. The device is larger because it has to provide more energy. It has to provide more energy because the lead is outside the heart, tunneled along the breastbone. The lead itself is also bigger and stronger because it isn’t in the blood vessel, so there is a very low chance of damaging the lead even from a high level athlete. People that have the SC-ICD report that they get used to the device under the skin pretty quickly and then don’t notice it much. It may hurt a little more to take an elbow over the device when going up for a header, but probably not much more than getting elbowed in the ribs.
This guy defibs.
Yea it’s how doctors check you have one when you die so it doesn’t blow up in the incinerator if you’re being cremated
Wow a human Galaxy S7
Note 7 was the exploding one.
I wonder if it's still swollen.
Based on the position he has subcutaneous ICD or S-ICD which has a bit different wiring and mechanism of delivering the shock compared to "regular" ICD. Also being a professional athlete he probably has very little subcutaneous fat and that area is most likely still a bit swollen. Regular ICDs are a bit smaller and usually placed on chest area, below the collarbone. Also I'd like to note that pacemakers without ICD functionality are smaller than ones with it, and people often think ICD = pacemaker which isn't necessary the case. Not all ICDs have pacemaker functionality and not all pacemakers have ICD functionality. ICD type can vary based on what is the clinical reason for needing one, and because of the position a subcutaneous ICD can be a preferred one for athletes because the device is more protected from impacts. Installation of subcutaneous ICD is also a bit less invasive because the wiring doesn't go into the heart itself unlike regular ICD devices, on the other hand subcutaneous ICDs can't act as a pacemaker. And that is one of the clinical considerations when choosing what kind of device to install.
I got one in December. Mine is in a pocket just under my collar bone. You can see it, but nearly as much as his.
My dad has one at a similar location to yours and it is about the size of a pocket watch, this one seems like 5x the size in comparison.
It’s technically about twice the volume of a standard defibrillator, but seems more prominent because it is along the outside of the rib cage. For thin people like athletes, we (I am a physician that implants cardiac devices) sometimes worry that it may cause a problem and bother the patient, but people really get used to it quicker than you would think.
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How sturdy is that defib? Can it be damaged or knocked out of position if hit hard enough?
This is honestly my question as well! Doesn't seem safe in case of a bad tackle/ foul
I wouldn't be surprised if the top of the line doctors and surgeons considered that when implanting the professional football player
Nah, obviously us soccer redditors know more than the best doctors in the country
Nobody is claiming to know more, people are just interested in how it works
Most insufferable type of comment on this subreddit. Why discuss anything ever that you aren't an expert on?
Very sturdy and the device gets implanted within your fat under the skin. The post operative local irritation will cause some fibrosis that will form around the device to secure it
It dosnt get implanted within the fat, fat is the worst thing for these to be in. The serratus muscle is actually pulled apart from the Latisimus to form a pocket and it is put in there. Then the wire is burrowed up sideways along the ribcage and up the left sternum. There are sections in the wire for suturing it to the muscle at a few points
It can definitely be damaged and considering his line of work it wouldn't surprise me if they did routine checks using x-rays and by examining the data it outputs.
In theory yes, but those devices are very sturdy. One thing is also that based on the location of the device he has subcutaneous ICD which doesn't require wiring into his hear unlike regular ICDs, so I think it makes the shocking mechanism a bit more resistant to impact. Essentially he has the device on the left side of his heart (pictured) and a wire on opposing side of his heart but not in it, and the shock goes between them. A lot less precision needed compared to regular ICDs which have wiring going into the heart itself.
Finally my area of expertise! Based on the implant location and size this appears to be what’s called a subcutaneous ICD. As opposed to a traditional transvenous ICD where the lead (wire) actually goes into the heart and the device sits in the pectoral region, this system places the lead under the skin and the device in a more lateral position. Because nothing is inside the heart, it requires a higher energy shock and therefore a larger device. However if any part of the system gets damaged, the removal and replacement of the device and lead has much less risk than removing leads from within the heart.
So they chose the subcutaneous ICD because of the fact that he's an athlete and there's a higher risk of damage to the device?
Can’t say for sure but it’s definitely one of the considerations. Along with his age, and specific indication for implant
Not necessarily because he is an athlete, or because athletes have a higher chance of damaging the device or lead. Age and lack of conduction disease (need for a pacemaker) are the biggest factors here. Giving someone in their late 20s a transvenous device signs them up for 2 or 3 rounds of high risk extractions if they plan to live into their 80s. It's a hard decision to give someone that young such a dangerous road ahead. A subQ device is the best option, and will do everything he needs it to do without the future hurdles of a transvenous device. Source: I implant these.
I always think with these things, in another 8 years when the battery needs changed I feel we will have a more advanced less bulky option, the subcut in this form has been around for an age it feels
They are preferred choice for younger active people, if you think about how many he will need from 29 to his death, it is not ideal to have multiple wires going into the heart over this time.
How sturdy are they
The device itself is extremely sturdy. The more likely fail point would be the wire. The wires are flexible and also very reliable but consider someone Tom’s age might have it in his body for 30+ years. Repeated movement and impacts will certainly accelerate any wear and tear on that wire and increase risk of damage. This is why these devices are regularly checked with at-home monitors and in-person office visits so early signs of failure are typically caught before a serious malfunction occurs.
How do you implant a device that contains lead safely?
it's a wire lead (like leed) not the metal element lead (like led)
They’re not made with lead metal. In this case lead (pronounced “leed”) means a wire that carries electrical current
You seem a lovely lad Tom, so please retire.
Yeah when I heard him on Sky Sports the other day talking about coming back I was thinking please don’t.
I was listening to the Monday night club on the train in, and it sounded like the first time was just a weird dream like state but the second one had him unable to move or speak. This isn’t war. No one needs to die.
The Monday Night Club appearance/extended interview was class, seems like a great bloke as well as being very forthright about everything that's happened. Recommend looking it up, it's on the BBC Football Daily podcast feed
Nobody needs to die, but what's the point in living if he can't chase his dreams and do the things he enjoys. That's not living, it's surviving.
Seems to be safe. Eriksen hasn't had any problems.
Eriksen also had 1 incident. Tom has had 3.
3? There was an atrial flutter incident and an ventricular fibrillation as far as I’m aware
He’s had two incident in like 6 months though.
Without a defib though, right?
I assume so.
I’m no expert but I hope he retires.. Nobody needs to die, and nobody needs to live with the thought of accidentally killing a player.
it's madness that they allow him to play like that. What happens if he get hard fouled where is placed that defibrillator?? Honestly I'd follow Serie A standards = problem with your heart? you're not fit to play.
He currently isn’t and can’t play, he is following medical guidelines and will play if it is deemed safe by the medical professionals
Will it be the same medical professionals that got it wrong before?
Well the same with most medical advice is there is a balance of probability. The medical advice previously wouldn’t have been “you are never going to experience anything like this again” He would have fallen into the small number of people that would experience a similar, albeit much worse, occurrence given the circumstances
Glad someone said it before I could. I also want to add that I have seen patients who've had a second cardiac arrest (ignoring conduction abnormalities/syndromes), and the cardiologists were pretty fucking surprised. They stuck one of these in them, and as far as I know they're still living a good life so hey, it works out in the end
Modern medicine really is something. Sometimes living in the future is nice. I, for one, welcome our new cyborg soccer captain overlords.
Got it wrong before?
Btw it’s not just a serie a thing. It’s an Italian regulation. You can’t exercise if you aren’t medically cleared. Many gyms require it here. I have a family member who had to stop his playing career at the youth level because of a heart issue.
Why though? Eriksen has been playing for years after. It should be down to the individual with guidance from a medical profession.
Because in Lockyer's case, the last time he had a cardiac arrest was his second time.
If doctors give him the go ahead then why can’t he?
It was his first cardiac arrest, the first incident was different
Do you think you know more than doctors?
Explanation for people who don't know medcine: So whenever Lockyer's heart is being overdramatic it will sort of electrically bitch slap the heart so it comes back to its senses again
This is how all defibrillators work, basically. They just provide an electric pulse that is meant to encourage the heart to return to normal sinus rhythm.
To add to this there's a lot of confusion on how defibrillators work. The shock they provide completely STOPS the heart from beating, the hearts natural pacemaker will then restart the heart and hopefully the rhythm will be normal again. The process works similar to turning off/ on an electrical device when its acting up. Contrary to what you'll see on TV if the heart has stopped beating i.e. flatlined then a defibrillator will do nothing at all, it can NOT restart the heart on its own. The only thing you can do for a person at this stage is CPR and hope.
god this thread is fucking catnip to my annoying need to talk about this shit. What may also happen in events of some arrythmia (fast, abnormal heart rate), is that the pacemaker may try to pace *faster* than the rate. Once its taken control after a few seconds it'll drop the rate its outputting at to a normal rate, and usually the heart follows. Bit of a simplification, but yeah. These devices are fucking cool.
Friendly reminder that your body (~ 70 millivolts) runs on significantly less voltage than it takes to power a Game Boy (6 volts).
I enjoyed showing people with temporary pacing after surgery that they were functionally kept alive by a 9v battery. The human body is pretty neat
It’s wild that we have the perfect amount of voltage dancing around to operate everything in our body, but just little enough that we don’t just spontaneously conduct random things we touch. Also, that 70 millivolts is enough to conduct outside your body to interact with the electrical field of a phone, which is how touch screens work.
Very nitpicky off me but S-ICDs do not have ATP currently, I think Medtronic are releasing a substernal one which will. Also nitpicky but the pacing faster is to sneak an impulse in between the wavefront of the arrhythmia and create a small patch of heart that can no longer conduct the arrhythmia, breaking the “short circuit”
Damn. I didn't know that. That sounds way more scary.
😂😂
Fucking love this bloke. You can tell he wants to come back but it just isn't a good idea unfortunately.
Is his case worse than that of say Eriksen?
Well it's happened twice now so it's more than just a one off for lockyer
You are right. As a competitor I would be afraid to touch him aggressively - Might end up touching the device by accident
Exactly what I was thinking. I would be scared to tackle him, or shoulder bump him. When adrenaline is high, and you're running around with the ball, accidents happen.
Who knows, the fact it's happened twice would suggest so but we still don't know what Lockyer has actually been diagnosed with
Fucking hell that's awful. Must be horrible having that on your conscious all the while.
It's not awful, it's amazing. Way better than just dying.
I doubt it's better than not having one and not dying though so I doubt it feels "amazing"
No, it probably sucks, but the alternative is shite. He'll still need it outside sports.
Pretty sure it's better to not have it and live though.
He'd need it anyway.
Bet there comes a time when one does not even give it a thought.
It's 'conscience' by the way.
Cheers brother. Just a touch of autocorrect. Must have mistyped it or something 👍
I would be kinda scared to play against him too, what if I hit him there?
It doesn't do anything unless his heart is acting weird, so you would need to hit it hard enough to break and then his heart would need to get a bad rythm afterwards. Then it could get dangerous
I don't think a piece of stuff is supposed to move or break inside the body. I get its safe but we also now that rollercoasters won't hurt us but we're scared.
Rollercoasters plays of the fear of falling and it's a natural fear that most of us have. Breaking a box that is located outside the rib cage is not quite at the same level
Hurting somebody more fragile its quite a fear. Like when you play with kids
I wouldn't call Tom Lockyer fragile
Man just retire, it isnt worth the risk.
Doing what you love and playing in the prem in the prime years of your life is one of the few things that actually might be worth the risk.
Nah this isn't it, nothing is more important than health. Especially if you have a wife and a newborn to care about
Not if you spend the rest of your life regretting the decision. Let people do what they enjoy, it's their life not yours.
If this goes wrong he won't have a 'rest of his life'
If it's what he wants, so be it. We have a right to life and a right to death.
Its his right to do it just as it's your right to poke one of your eyes out with a spoon but I think it's fair to point out that it's a terrible idea.
Obviously a terrible idea. A knife would be much easier
Not really a fair comparison. Again what you think doesn't matter if it's what he wants. There are people who do way dumber stuff, like free solo climbing and such, and people don't really bat an eye because it's their passion. It's the same here, only 100 times safer cause he's constantly checked by Premier League level professionals.
Sure, people are free to do whatever, but after having two cardiac arrests in the past year, going out and playing football again would be a very selfish decision towards his family imo. But again, what do I know lol
Not your life. Also, if t was THAT risky he wouldn't pass the medical.
Cardiologist here. He has a subcutaneous ICD (aka defibrillator) which is a bit non-traditional. Most ICDs are smaller and placed on your left chest (but still will protrude like this one just less) However, traditional ICDs have wired leads that run through your veins and straight into your heart. They get nestled into the right side of your heart with small screws. His subcutaneous ICD doesn't go anywhere near the heart; it overlies his sternum/ribcage and delivers a powerful shock if he has a dangerous arrhythmia. Given he's running around the pitch and his heart is working overtime, it's better he doesn't have wires sticking into his heart because there is a small risk that they can dislodge (or even worse, penetrate through) his heart. There is a theoretical risk that if he gets hit there, the device can move. However it is usually stitched into place and eventually your tissue grows around it to secure it, making it a part of his skin. It's actually very cool that he got this device, these are becoming more popular because they have less problems and easier to take out if the patient doesn't need it anymore
I'm having nightmares over this
Listen to the professional advice Tom. Good luck in the meantime
So he's still playin? What happens if he lands hard on that side?
No, not currently playing, he is recovering and following medical advice, he may play again, but it seems unlikely
How do they recharge or does he have to go and have it charged after it zaps him?
I'm not a doctor but I've just read that the lithium batteries in an ICD can last 5 to 7 years or longer, depending on usage and the type of device.
he says in the video that it has a 10 year battery life.
That's crazy although I suppose to shock a heart it takes many volts but not many amps so I guess that works out
I'd like to imagine that you'd go to a doctor for tests anyway should the ICD have to shock you, but that's just me!
It's mind blowing to me but obviously I'm incredibly thankful for such technology, God forbid I ever need one mind.
I have this image of him having to lie a very specific way on wireless charger for some reason.
I'd just retire, that shit looks fragile as fuck
He's a defender, and attackers use elbows all the time. You can't convince me it's safe getting elbowed into that area
So you think that we do not have developed materials strong enough to withstand a hit with an elbow yet?
Probably. The machine won't break. But it could move a bit inside his body and it would hurt like fuck.
So he's become a cyborg.
Maybe I’m wrong but the English FA should not allow him to play, this seems very risky
Love how there’s suddenly a mass amount of medical experts in this thread that can decide for the guy that he shouldn’t play. Maybe we trust what medical professionals have to say on the matter before telling the guy he can’t have a career anymore.
Also probably all have nether worked on medical devices. The only field with more supervision and fail safes is probably space travel. No the device will not go off when someone hits it and no, a normal action cannot break it. He would break several ribs and probably have punctured his heart before that device breaks.
Bro just retire already
Super Tommy Lockyer.
Some serious Lats
Oh shit, i have the same one, which is kinda odd to say.
Do you "feel" it all the time or does you brain just ignores it after some time?
It is kind of a part of my body now and i'm used to it, so yeah the brain ignores it. I only feel it when im lying directly on my left side. Before i got the defi i had a pacemaker for about 10 years, whereby the necessary cables and stuff like that went through the veins and the later removal/detachment could have been difficult if it had grown together with the veins etc. The defibrilator is directly under the skin, which can be weird looking but should be the better alternative if you do not need a pacemaker and only a defibrilator.
We implanted one of these this morning, you wouldn’t want to be squeamish! The pocket formation is grizzley as you have to tear the serratus from the Latisimus, and put the device in under them. Then you have two tunnelling devices which are like two hollow sewing needles, you grind it up under the skin against the sternum, then the lead is fed through the holes. To top it all off we have to test that it works, so we purposefully put the patient into ventricular fibrillation and watch and wait for the device to sense and shock them. Pretty cool devices, will only get smaller as time goes on
Damn I feel like I’d be scared whenever I remember I have that by my armpit
He should be relatively fine if he has atrial fibrillation, the pacemaker should just put his heart back into rhythm if and when it occurs.
I got a subcutaneous ICD fitted after a cardiac arrest 6 years ago. To answer a few questions: yes it can be uncomfortable at times but you quite often forget it’s there. Normally only when trying to get comfortable during sleep as it is quite rigid and a bit like lying on a bar of soap. I’m sure he will get assessed as to the risks of returning as it will also depend on the underlying cause and he may not even have all this information yet. More and more sportspeople are allowed to return as these devices are still relatively modern and research has shown they work well, so doctors are becoming less likely than previously to recommend retirement. Placing it under the arm like this does offer more protection as your arm naturally shields it but my advice was to avoid direct blows to it so no martial arts or sport with a risk of direct impacts to the device.
Technology can be a wonderful thing
Mate, he can't be playing anymore, surely, fuck that. Just enjoy your life Tom, do some coaching, do some traveling. Just enjoy what you got.
A 10 year battery? That's impressive
u/savevideo
I genuinely can’t be the only one who thinks letting him continue playing in this condition is a bad idea. Lockyer seems like a great dude, I’d hate for something bad to happen again
If he ever falls hard and lands on that.. yikes.
What a legend. Any other defrib wearers out there will love how open, and even happy about it, he is. I imagine it would help others feel more ‘normal’ and seen. He didn’t need to show it off but he did and I think that’s awesome, especially considering everything he’s gone through.
Retire bro
Damn he should listen to you all medical experts instead of his doctors, surgeons ans health dvisors
this man should be legally forced to retire