Implantable Cardioverter Defibrillator (ICD)

Implantable Cardioverter Defibrillator

An ICD is a small, battery-powered device that continuously monitors your heart rhythm. If it detects a dangerously fast or irregular heartbeat, it can deliver a small electrical impulse—or a stronger shock if needed—to restore a normal rhythm.

ICDs are used to treat sudden cardiac arrest in people who are at high risk for ventricular tachycardia or ventricular fibrillation due to a weakened heart muscle, scar from a previous heart attack or specific conditions which put you at risk of dangerous electrical abnormalities. There are several types of ICDs, including traditional devices with leads inside the heart and newer subcutaneous ICDs that sit under the skin with a lead outside the heart.

What happens after the procedure?

You will need to take it easy for the first couple of weeks:

  • Avoid driving for at least two weeks (the driving restriction could be longer depending on the indication for the defibrillator implant).
  • The guidelines for commercial driving are different and will be discussed if they apply to your situation.
  • Limit arm movement on the side of the ICD to allow the leads to settle.
  • You should see your GP 7- 10 days after the procedure to remove the dressing and check the wound.

After that, you will have regular check-ups either in person or through our remote monitoring service to ensure the ICD is functioning well.

How is the procedure done?

  • A canula or drip will be placed in your arm to allow the medical team to give medications.
  • You may receive an antibiotic to reduce the risk of infection.
  • A sedative will be given to help you relax.
  • A local anaesthetic will numb the area just below your collarbone.

 

Your cardiologist will make a small incision and create a pocket under the skin to place the ICD. One or more leads (thin wires) will be guided through a vein into your heart using X-ray imaging. Once the leads are in place, the ICD will be connected and tested to ensure it is working properly. The incision will then be closed with dissolving stitches.

What are the risks?

  • Bruising or bleeding around the device site

Less common risks

  • Dislodgement of the ICD leads, which may require repositioning.
  • Infection in the pocket where the ICD is placed or bloodstream related infection.
  • Collapsed lung (pneumothorax)
  • Perforation of the heart chambers (pericardial effusion and cardiac tamponade)
  • Blood clots in the veins of the upper limb (deep vein thrombosis)
  • Clots that travel to the lungs (pulmonary embolism)
  • Heart attack
  • Stroke
  • Death, though this is extremely rare.

Let all your healthcare providers know you have a defibrillator—especially before having an MRI or surgery.

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