Heart Rhythm Center

What Is an ICD?

An implantable cardioverter defibrillator (ICD) is a small electronic device that is placed in your chest and monitors your heart rhythm. When an ICD detects a very fast, abnormal rhythm in the lower chambers of the heart called the ventricles, it delivers energy to the heart muscle to correct the dangerous rhythm.

Who needs an ICD?

An ICD may be recommended for people who:

  • Had a prior episode of sudden cardiac arrest
  • Had a prior episode of ventricular fibrillation
  • Had at least one episode of ventricular tachycardia
  • Had a prior heart attack and have an increased risk for sudden cardiac arrest or sudden cardiac death
  • Have hypertrophic cardiomyopathy

Types of ICD

There are three types of implantable cardioverter defibrillators. All ICDs have the ability to convert a dangerous heart rhythm back to normal as well as provide electrical impulses to help the heart beat normally or "pace" the heart. Your doctor will discuss what type of ICD is best suited for you.

  • Single Chamber: An ICD lead is attached to only one chamber of the heart, the right ventricle.
  • Dual Chamber: ICD leads are attached to two chambers on the same side of the heart: right atrium and right ventricle.
  • Bi-Ventricular: The most complex type of ICD is designed specifically for patients with heart failure and has leads attached to three chambers: right atrium, right ventricle, and left ventricle.

Before the Procedure

Should I take my medications?
Prior to the procedure, your doctor will discuss with you what medications to continue taking or what medications to stop.

Can I eat before the procedure?
You will not be able to eat or drink anything after midnight before your procedure. If you must take medications, you will be instructed to take them with a very small sip of water. When brushing your teeth, do not swallow any water.

Where does the procedure take place?
You will be instructed on what time to arrive and where to arrive the day of your procedure. You can call the office at (408) 879-5900 if you have any questions.

What can you expect during the procedure?

The procedure typically takes 1 to 3 hours. The ICD is implanted with numbing medication injected into the surgical site as well as intravenous pain and relaxation medication administered by an anesthesiologist. Flexible insulated wires (leads) are inserted into a vein under or near your collarbone, typically on the left side. The lead(s) are guided with the help of X-ray images to the proper chamber of your heart. The other end of the lead is attached to the generator which is implanted in a pocket under the skin in the upper chest. Your new device and new lead(s) will be tested after they are properly implanted. Testing the device may require "shocking" your heart. The anesthesiologist will heavily sedate you so that you will not be awake during the test.

What to expect after implant?

After implant, you may have some discomfort around the incision area, which can remain tender and swollen for a few days or weeks. Pain medication will be provided by your physician so that you have adequate pain relief.

You will stay in the hospital overnight. Your implantable cardioverter defibrillator device will be re-evaluated the morning after implant and, if everything is stable, you will be discharged home. You will receive specific instructions about how to care for yourself after the procedure including medication guidelines, wound care, activity guidelines, and device care and maintenance.

What happens after I go home?

You will be periodically followed in our Arrhythmia Device Clinic. You will be given follow-up instructions prior to discharge.

ICD therapy is only one part of a comprehensive treatment program. It is important that you continue to take your medications, make dietary changes, live a healthy lifestyle, and keep your follow up appointments. We want you to be an active member of your treatment team.

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