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Intracardiac Defibrillator Device Implantation

An ICD is a battery-powered device placed under the skin, often just below the collarbone, that monitors heart rhythms. It is somewhat different from the traditional pacemaker. Thin wires connect the ICD to your heart. It works 24 hours a day.

A pacemaker helps control abnormal heart rhythms (arrhythmias). It uses electrical pulses to prompt the heart to beat at a normal rate. An ICD delivers shocks when it senses dangerous rhythms. This treatment is called defibrillation. This helps control life-threatening arrhythmias, especially those that can cause sudden cardiac arrest. Most new ICDs can act as both a pacemaker and a defibrillator.

ICDs offer a host of other sophisticated functions such as storage of detected arrhythmic events and the ability to perform electrophysiologic testing. Stored information can help your doctor modify the ICD for your needs and plan future treatment.

Why choose Presbyterian for your intracardiac defibrillator device (ICD) implantation?

Presbyterian Heart and Vascular Care has a skilled electrophysiology team who can provide a wide range of cardiac rhythm treatments. Their electrophysiology cardiologists are trained in many different techniques and procedures, many of which can provide you with a shorter recovery period and the opportunity to recover at home.

Who is eligible for an intracardiac defibrillator device (ICD) implantation?

ICDs are useful in preventing death in patients with ventricular tachycardia (fast heartbeat) or fibrillation (irregular heartbeat). ICDs also have a role in preventing cardiac arrest in high-risk patients who are at risk for life-threatening arrhythmias.

Before a patient is considered a candidate for an ICD, the arrhythmia must be life threatening. Doctors have likely ruled out correctable causes of the arrhythmia, such as:

  • Acute myocardial infarction (heart attack).

  • Electrolyte imbalance and drug toxicity.

  • Myocardial ischemia (inadequate blood flow to the heart muscle).

What conditions can be treated with an intracardiac defibrillator device (ICD) implantation?

Your doctor may recommend an ICD if you or your child is at risk of a life-threatening arrhythmia because of having:

  • A heart attack.

  • Brugada syndrome.

  • Ventricular arrhythmia.

  • A sudden cardiac arrest.

  • Long QT syndrome ("long QT" refers to an abnormal pattern seen on an EKG (electrocardiogram).

  • A congenital heart disease or other underlying conditions for potential cardiac arrest.

How do I prepare for an intracardiac defibrillator device (ICD) implantation?

You may be given blood tests to assess your risk of bleeding or infection.

Implantation of an ICD usually involves a combination of local anesthesia and conscious sedation. Conscious sedation may be administered in the form of intravenous (IV).

Typically, the procedure takes 30 to 90 minutes to complete.

What should I expect during my intracardiac defibrillator device (ICD) implantation?

A battery-powered pulse generator is implanted in a pouch under the skin of the chest or abdomen, often just below the collarbone. The generator is about the size of a pocket watch. Wires or leads are positioned to run from the pulse generator to positions on the surface of or inside the heart. These wires enter the body through blood vessels, avoiding the need for open-chest surgery.

How do I care for myself after my intracardiac defibrillator device (ICD) implantation?

You most likely can resume a near-normal lifestyle. Ask your doctor what types of machines or equipment you should avoid. Also, ask what you can and cannot do when you have an ICD.

It might be risky to be around devices with strong magnetic fields. The longer you are exposed to the potentially interruptive device, the more likely it will affect your ICD’s performance.