Implantable Cardioverter

Defibrillator Implantation

Overview

ICDs are useful in preventing sudden death in patients with fibrillation. ICDs are pager-sized devices that are placed in your chest to reduce your risk of dying if the lower chambers of your heart (ventricles) go into a dangerous rhythm and stop beating effectively (cardiac arrest).

You may need an ICD if you have a dangerously fast heartbeat or a chaotic heartbeat that keeps your heart from supplying enough blood to the rest of your body. ICDs differ from a pacemaker, stopping abnormal heartbeats and continuously monitoring your heartbeat, delivering electrical pulses when necessary.

What to Expect

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Before the Procedure
  • You will be asked to remove any jewelry or other objects that may interfere with the procedure.
  • You will be asked to remove your clothing and will be given a gown to wear.
  • An IV line will be started in your hand or arm for injection of medicine and fluids, if needed.
  • You will be asked to empty your bladder
During the Procedure
  • You will be placed on your back on the procedure table.
  • You will be connected to an electrocardiogram (ECG) monitor that records the electrical activity of the heart during the procedure. Your vital signs will also be monitored during the procedure.
  • Large electrode pads will be placed on the front and back of the chest.
  • You will receive sedative in your IV to help you relax, but you will be awake during the procedure.
  • An anesthetic will be injected into the insertion site.
  • A small incision will be made once anesthetic has kicked in
  • A battery-powered pulse generator (about the size of a pocket watch) is implanted in a pouch under the skin of the chest or abdomen, often just below the collarbone. Wires run from the generator to the positions on the surface of or inside the heart and can be installed through blood vessels, eliminating the need for open-chest surgery.
After the Procedure

After the procedure, you may be taken into a room for observation or returned to your hospital room. A nurse will monitor your vital signs. After resting, you may get out of bed with help. You will be able to eat and drink once you are completely awake. Your arm may sling for a day or so. The insertion site may be sore and you may be given medicine if needed.

You should be able to leave afterward, however, it is common to spend at least one night in the hospital after ICD implantation for observation.

FAQs

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Why might I need an ICD?

Your doctor may recommend an ICD if you are at risk of a life-threatening ventricular arrhythmia because of having:
Had a ventricular arrhythmia
Had a heart attack
Survived sudden cardiac arrest
A congenital heart disease or other underlying conditions for sudden cardiac arrest

Will an ICD cure my heart rhythm problem?

No, to cure means to permanently eliminate the condition and that’s not what an ICD does. Rather, and ICD acts instantly if your heart rhythm changes for the worse. It treats a problem each time it occurs.

How does an ICD work?

Most patients who have received shocks from an ICD describe them as startling, jolting, and unsettling; but not painful.

After the device is implanted, can I resume normal daily activities?

In most cases, once the ICD begins to control your heart rhythm, life can return to normal. You should be able to return to work, school, and usual activities including driving, sexual relationships, and exercise. How long it takes to resume normal activities depends on the individual patient and other medical problems they may have.