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.