What is Implantable cardioverter defibrillator (ICD)?
An implantable cardioverter-defibrillator (ICD) is a small battery-powered device placed in your chest to monitor your heart rhythm and detect irregular heartbeats. An ICD can deliver electric shocks via one or more wires connected to your heart to fix an abnormal heart rhythm.
You might need an ICD if you have a dangerously fast heartbeat (ventricular tachycardia) or a chaotic heartbeat that keeps your heart from supplying enough blood to the rest of your body (ventricular fibrillation). Ventricles are the lower chambers of your heart.
ICDs detect and stop abnormal heartbeats (arrhythmias). The device continuously monitors your heartbeat and delivers electrical pulses to restore a normal heart rhythm when necessary. An ICD differs from a pacemaker — another implantable device used to help control abnormal heart rhythms.
Why it’s done?
You’ve likely seen TV shows in which hospital workers “shock” an unconscious person out of cardiac arrest with electrified paddles. An ICD does the same thing only internally and automatically when it detects an abnormal heart rhythm.
An ICD is surgically placed under your skin, usually below your left collarbone. One or more flexible, insulated wires (leads) run from the ICD through your veins to your heart.
Because the ICD constantly monitors for abnormal heart rhythms and instantly tries to correct them, it helps when your heart stops beating (cardiac arrest), even when you are far from the nearest hospital.
How an ICD works:
When you have a rapid heartbeat, the wires from your heart to the device transmit signals to the ICD, which sends electrical pulses to regulate your heartbeat. Depending on the problem with your heartbeat, your ICD could be programmed for:
- Low-energy pacing: You may feel nothing or a painless fluttering in your chest when your ICD responds to mild disruptions in your heartbeat.
- A higher-energy shock: For more-serious heart rhythm problems, the ICD may deliver a higher-energy shock. This shock can be painful, possibly making you feel as if you’ve been kicked in the chest. The pain usually lasts only a second, and there shouldn’t be discomfort after the shock ends.
Usually, only one shock is needed to restore a normal heartbeat. Sometimes, however, you might have two or more shocks during a 24-hour period.
Risk Factors
Risks associated with ICD implantation are uncommon but may include:
- Infection at the implant site
- Allergic reaction to the medications used during the procedure
- Swelling, bleeding or bruising where your ICD was implanted
- Damage to the vein where your ICD leads are placed
- Bleeding around your heart, which can be life-threatening
- Blood leaking through the heart valve where the ICD lead is placed
- Collapsed lung (pneumothorax)
Results
ICDs have become standard treatment for anyone who has survived cardiac arrest, and they’re increasingly used in people at high risk of sudden cardiac arrest. An ICD lowers your risk of sudden death from cardiac arrest more than medication alone.
Although the electrical shocks can be unsettling, they’re a sign that the ICD is effectively treating your heart rhythm problem and protecting you from sudden death. Talk to your doctor about how to best care for your ICD.
After the procedure, you’ll need to take some precautions to avoid injuries and make sure your ICD works properly.
Short-term precautions
You’ll likely be able to return to normal activities soon after you recover from surgery. Follow your doctor’s instructions. For four weeks after surgery, your doctor might ask you to refrain from:
- Vigorous above-the-shoulder activities or exercises, including golf, tennis, swimming, bicycling, bowling or vacuuming
- Lifting anything heavy
- Strenuous exercise programs
Long-term precautions
Problems with your ICD due to electrical interference are rare. Still, take precautions with the following:
- Cellular phones and other mobile devices: It’s safe to talk on a cellphone
- Security systems: After surgery, you’ll receive a card that says you have an ICD.
- Medical equipment: Let doctors, medical technicians and dentists you see know you have an ICD.
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