Automatic Cardioverter Defibrillator Implantation
(Implantable Cardioverter Defibrillators [ICD]; Automatic Implantable Cardioverter Defibrillator [AICD])
Definition
An implantable cardioverter defibrillator (ICD) is a small, battery-operated device. It helps the heart beat normally. ICD implantation is surgery to put an ICD into the chest.
Implanted Cardioverter DefibrillatorCopyright © Nucleus Medical Media, Inc. |
Reasons for Procedure TOP
This procedure is done to correct certain abnormal heartbeats such as:
- Bradycardia—heart beating too slowly
- Ventricular tachycardia—heart beating too fast
- Ventricular fibrillation—heart muscle not pumping, just shaking
In some people, abnormal heartbeats can raise the risk of cardiac arrest or sudden death. An implanted ICD can help prevent this.
Possible Complications TOP
Problems are rare, but all procedures have some risk. The doctor will talk about problems that could happen, such as:
- Bleeding
- Damage to nearby structures
- Infection
- Unwanted shocks
- Problems with the device
Things that may raise the risk of problems are:
- Smoking
- Excess alcohol use
- Long term diseases such as diabetes or obesity
What to Expect TOP
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from surgery
- Tests that will need to be done before surgery
Anesthesia
The doctor will give:
- Local anesthesia—the area will be numb
- Medicine to help you relax
After the ICD is in place, it will need to be tested. General anesthesia will be used for this step. You will be asleep.
Description of the Procedure TOP
The area where the ICD is to be implanted will be cleaned. A small incision will be made below the collarbone.
A wire, called a lead, will be threaded through a vein in the upper chest to the heart. X-rays will be used to watch the lead move through the vein to the heart. The signals between the heart and the ICD will be carried on this lead.
A pocket is made in the incision area. The ICD will be implanted into the pocket.
Once in place, the ICD will be tested. This is to make sure it shocks the heart properly. Precautions will be taken to make sure this is a safe process. When the ICD is working properly and in the right place, the incision will be stitched up. A bandage will be placed over the site.
How Long Will It Take? TOP
About 1 to 3 hours
Will It Hurt? TOP
Some pain and stiffness around the area is common for a while.. Medicines and home care help.
Average Hospital Stay TOP
1 to 3 days
Postoperative Care TOP
At the Hospital
The day after the implant, you will have an ECG and blood tests. The ICD function may be checked again. You may be sedated.
During your stay, the hospital staff will take steps to lower your risk of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incision covered
There are also steps you can take to lower your risk of infection, such as:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
At Home
It usually takes a week or so to recover.
Call Your Doctor TOP
Call your doctor if you are not getting better or you have:
- Signs of infection, such as fever or chills
- Redness, swelling, excess bleeding, or discharge from the incision
- A shock from the device
- Pain that you cannot control with the medicine
- Coughing
- Lasting nausea or vomiting
Call for medical help right away for:
- Chest pain
- Breathing problems
- Lightheadedness— and there is no shock
- Symptoms that do not go away after a shock
- 3 or more shocks in a row
If you think you have an emergency, call for medical help right away.
RESOURCES:
American Heart Association
http://www.heart.org
Heart Rhythm Society
https://www.hrsonline.org
CANADIAN RESOURCES:
Canadian Cardiovascular Society
http://www.ccs.ca
Heart and Stroke Foundation
http://www.heartandstroke.ca
REFERENCES:
Implantable cardioverter defibrillator. Heart Rhythm Society website. Available at: https://upbeat.org/common-treatments/implantable-cardioverter-defibrillator. Accessed August 30, 2021.
Implantable cardioverter defibrillator (ICD). EBSCO DynaMed website. Available at: https://www.dynamed.com/device/implantable-cardioverter-defibrillator-icd-16. Accessed August 30, 2021.
Implantable cardioverter-defibrillators (ICD). Stanford Health Care website. Available at: https://stanfordhealthcare.org/medical-treatments/i/icd.html. Accessed August 30, 2021.
Kamp NJ, Al-Khatib SM. The subcutaneous implantable cardioverter-defibrillator in review. Am Heart J. 2019;217:131-139.
Pacemakers. EBSCO DynaMed website. Available at: https://www.dynamed.com/device/pacemakers. Accessed August 30, 2021.
Last reviewed July 2021 by
EBSCO Medical Review Board
Nicole Meregian, PA
Last Updated: 8/30/2021