Implantable Cardioverter Defibrillator (ICD) Implantation

Will an ICD cure my heart rhythm problem?

No, it won't. Cure means to completely and permanently eliminate the condition and that's not what an ICD does. In some cases, an electrophysiogist can provide a cure for a rhythm disturbance, sometimes by performing an ablation. An implantable defibrillator is most commonly used as a part of a patient's treatment. It acts instantly if your heart rhythm changes for the worse. It treats the problem, each time it occurs. Many doctors use an ICD in combination with rhythm control medications called antiarrhythmics. The goal, in such cases, is to use medication to keep the rhythm from getting too fast and to use the ICD as a "failsafe" device to protect you if your heart rate increases dangerously despite the medication.

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Do shocks from an ICD hurt?

Most patients who have received shocks from their ICDs describe them as startling, jolting and unsettling, but not painful. It's easy to understand why. The ICD delivers a shock to prevent a dangerously fast heart rhythm. The device recognizes the rhythm, which may cause discomfort — dizziness, lightheadedness, palpitations, an "about-to-faint" feeling — and then suddenly, the ICD shock brings the rhythm back to normal. The jolt is a powerful one to control the heart without delay.

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Is the implant procedure an open heart operation?

No. Implanting an ICD is much simpler than it was a few years ago and often takes less than an hour.  The doctor who performs this procedure is the best source of information about what type of anesthesia will work best for you. As a rule, patients do very well with sedation to keep them in a light state of sleep, in combination with local anesthetic to numb the area where the device is implanted. The incision is usually a small one — three or four inches wide — and travels horizontally on the chest. After the ICD is in place and the incision is closed, the doctor applies a bandage to protect the site.  Most patients notice some soreness for about a week. Doctors advise patients with new ICDs to avoid getting the site wet for several days after it has been implanted.

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Where will the defibrillator be placed?

In the past, when ICDs were much larger, they were implanted in the abdomen. Now that they are smaller, doctors usually implant them in the chest, most often below the clavicle or collarbone, on the right or left side of the chest. You may feel and see the outline of the device under the skin.

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What kinds of patients will need ICDs implanted inside them?

You're a candidate for an ICD if you've had sustained ventricular tachycardia, survived a cardiac arrest or fainted from a ventricular arrhythmia. You might also benefit from an ICD if you have:  -A history of coronary artery disease and heart attack that has weakened your heart.  -A heart condition that involves abnormal heart muscle, such as enlarged or thickened heart muscle.  -An inherited heart defect that makes your heart beat abnormally. These include long QT syndrome, which can cause ventricular fibrillation and death even in young people with no signs or symptoms of heart problems.  -Other rare conditions that may affect your heart rhythm.