Navigate Up

Women's Center - A-Z Index

#
Y

Print This Page

Implantable cardioverter-defibrillator

An implantable cardioverter-defibrillator (ICD) is a device that detects any life-threatening, rapid heartbeat. If such a heartbeat, called an arrhythmia , occurs, the ICD quickly sends an electrical shock to the heart to change the rhythm back to normal. This is called defibrillation.

An ICD is made of these parts:

  • The pulse generator is about the size of a large pocket watch. It contains a battery and the electrical circuits that read the electrical activity of your heart.
  • The electrodes are wires, also called leads, that go through your veins to your heart. They connect your heart to the rest of the device. Your ICD may have 1, 2, or 3 electrodes.
  • All ICDs have a built-in pacemaker . Your heart may need pacing if it is beating too slowly or too fast, or if you have had a shock from the ICD.
Implantable cardioverter-defibrillator

A cardiologist or surgeon will usually insert your ICD when you are awake. The area of your chest wall below your collarbone will be numbed with anesthesia, so you will not feel pain. The surgeon will make an incision (cut) through your skin and create space under your skin and muscle for the ICD generator. Usually this space is made near your left shoulder.

Using special x-ray to see inside your chest, the surgeon will place the electrode into a vein, then into your heart. Then the surgeon will connect the electrodes to the pulse generator and pacemaker.

The procedure usually takes 2 to 3 hours.

Alternative Names

ICD; Defibrillation

Why the Procedure Is Performed

An implantable cardiac defibrillator is placed in people who are at high risk of sudden cardiac death. Reasons you may be at high risk are:

  • You have had life-threatening bouts of ventricular tachycardia (VT) or ventricular fibrillation (VF).
  • Your heart is weakened, too large, and does not pump blood very well. This may be from earlier heart attacks, heart failure, or cardiomyopathy (diseased heart muscle).
  • Certain congenital (present at birth) heart problems or genetic health conditions.
Click to download

Risks

Risks for any surgery are:

Possible risks for this surgery are:

  • Wound infection
  • Injury to your heart or lungs
  • Dangerous heart arrhythmias

An ICD sometimes delivers shocks to your heart when you do not need them. Even though a shock lasts a very short time, you can usually feel it.

This and other ICD problems can sometimes be prevented by changing how your ICD is programmed. It can also be set to sound an alert if there is a problem. Your electrophysiologist, the doctor who manages your ICD care, can program your device.

Before the Procedure

Always tell your doctor or nurse what drugs you are taking, even drugs or herbs you bought without a prescription.

The day before your surgery:

  • Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you might have.
  • Shower and shampoo well. You may be asked to wash your whole body below your neck with a special soap.
  • You may also be asked to take an antibiotic, to guard against infection.

On the day of the surgery:

  • You will usually be asked not to drink or eat anything after midnight the night before your surgery. This includes chewing gum and using breath mints. Rinse your mouth with water if it feels dry, but be careful not to swallow.
  • Take your drugs your doctor told you to take with just a small sip of water.

Your doctor or nurse will tell you when to arrive at the hospital.

After the Procedure

Most people who have an ICD implanted are able to go home from the hospital in 1 day. Most quickly return to their normal activity level. Full recovery takes 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 your ICD can be monitored. The doctor will check to see if the device is properly sensing your heartbeat, how many shocks have been delivered, and how much power is left in the batteries.

Outlook (Prognosis)

Your ICD will constantly monitor your heartbeats to make sure they are steady. It will deliver a shock to the heart when it senses a life-threatening rhythm. This device can also work as a pacemaker.

References

Epstein, A E, DiMarco, J P, Ellenbogen, K A, Estes, N A, 3rd, Freedman, R A, Gettes, L S, et al. (2008). ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation;117(21):e350-408.

Hayes DL, Zipes DP. Cardiac pacemakers and cardioverter-defibrillators. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, PA: Saunders Elsevier; 2007:chap 34.

Updated: 10/8/2012

Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, and Stephanie Slon.


©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com