Implantable Cardioverter-Defibrillator (ICD)

An ICD is a device that detects life-threatening, rapid heartbeats (arrhythmias). If it occurs, the ICD sends an electrical shock to the heart to restore a normal rhythm.

How it Works

An ICD is typically made up of two main parts:

  • The Pulse Generator: About the size of a pocket watch. It contains the battery and circuits that read your heart's activity.
  • The Electrodes (Leads): Wires that go through your veins to connect your heart to the device.

Note: Most ICDs also have a built-in pacemaker to help if your heart beats too slowly.

Why is it performed?

An ICD is recommended for people at high risk of sudden cardiac death due to:

  • Ventricular tachycardia (VT) or ventricular fibrillation (VF).
  • Weakened heart muscle (cardiomyopathy) from past heart attacks or heart failure.
  • Congenital heart problems or genetic health conditions.

The Procedure

The procedure usually takes 2 to 3 hours.

  1. Preparation: You will be awake, but the chest area will be numbed with anesthesia so you do not feel pain.
  2. Incision: The surgeon creates a space under the skin and muscle (usually near the left shoulder) for the generator.
  3. Placement: Electrodes are guided through a vein into the heart using X-ray.
  4. Connection: The leads are connected to the generator, and the device is tested.
Before your surgery:
  • Report any colds, flu, or fever to your doctor.
  • Do not eat or drink after midnight the night before.
  • Take only approved medications with a small sip of water.

Recovery & Aftercare

Most people go home within 1 day. Full recovery takes about 4 to 6 weeks.

Important: Arm Movement Restrictions

To ensure the leads heal correctly, follow these rules for 2 to 3 weeks:

  • Do not lift anything heavier than 10 to 15 pounds (4.5 to 6 kg).
  • Avoid pushing, pulling, or twisting your arm.
  • Do not raise your arm above your shoulder (unless cleared by your doctor).

Living with an ICD

  • Wallet Card: You will be given a card with your device details. Carry this with you at all times in case of emergency.
  • Regular Checkups: You will need regular appointments to check the battery life and ensure the device is sensing your heartbeat correctly.

Risks

As with any surgery, risks include infection, blood clots, or reaction to anesthesia. Specific risks for ICDs include:

  • Wound infection.
  • Unnecessary shocks (this can often be fixed by reprogramming the device).