Thursday, October 19, 2017

Implantable cardioverter-defibrillator

Table of Contents

The ICD continuously monitors the heartbeats to make sure they are normal. It only delivers a shock to the heart when it senses a life-threatening rhythm.

During the implantation of a pacemaker-type ICD, electrodes are inserted through the veins into the heart. The pulse generator is surgically buried under the skin of the chest, generally below the left collarbone.

Who needs an ICD?

An ICD can help prevent sudden death in those who have ventricular fibrillation (VF) or ventricular tachycardia (VT). Both of these conditions can make the heart stop pumping blood, which can cause you to suddenly pass out (lose consciousness) or even die. VF and VT are emergency situations that require quick medical treatment. Cardioversion (external defibrillation) can be used to shock the heart rhythm back to normal.

People who may receive an ICD include those who have:

  • Survived a cardiac arrest due to VF
  • Life-threatening episodes of VT
  • Survived a heart attack, but whose heart remains weak
  • Problems with the heart muscle, including dilated cardiomyopathy and hypertrophic cardiomyopathy, especially when unexplained fainting episodes have occurred
  • Reduced pumping function of the heart

Occasionally, an electrophysiological study (EPS) is needed to make sure you can have or need an ICD implanted.

What to expect after ICD implantation

Persons who have an ICD implanted rarely stay in the hospital longer than 1 day. Patients quickly return to their normal activity level. Full recovery occurs in about 4 to 6 weeks.

When you leave the hospital, you will be given a card to keep in your wallet. This card lists the details of your ICD and has contact information for emergencies. You should always carry this wallet card with you.

You will need to make regular visits to the doctor so the ICD can be monitored. The doctor will check to see if the device is properly sensing the heartbeat, how many shocks have been delivered, and how much power is left in the batteries. The ICD batteries are designed to last 5 to 8 years. When they are about to run down, the ICD generator must be replaced. This requires minor surgery.

The ICD generator is metal and will be detected by metal detectors such as those in airports or public places with safety checks. For air travel, public events, and admission to certain areas you will need to show your wallet card to the security personnel to prevent setting off any alarms.

Review Date: 07/12/2006
Reviewed By: Glenn Gandelman, MD, MPH, Assistant Clinical Professor of Medicine, New York Medical College, Valhalla, NY. Review provided by VeriMed Healthcare Network.

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