An implantable cardioverter-defibrillator (ICD) is a device that is similar to a pacemaker in function but has an additional component. An ICD is implanted when a person has had a cardiac arrest due to a life threatening abnormal fast heart rhythm or has a heart history that puts them at high risk of developing a life threatening abnormal fast rhythm. These rhythms are called ventricular tachycardia or ventricular fibrillation.
The device is implanted in the chest along with 1 or 2 wires or leads that go into the heart. It will continuously monitor the heart and if the ICD detects a life threatening abnormal fast rhythm it will either deliver a series of small electrical impulses or deliver high-energy impulses or a “shocks” to restore to a normal heart rhythm. The ICD has pacing capabilities as well and will send electrical impulses to stimulate the heart muscle to beat if it detects a slow heart rate.
The procedure for an ICD implant typically takes about a 1 to 2 hours and is performed in the electrophysiology lab or a special procedural room in the hospital. During the initial part of the procedure you will be given medication through your IV to relax you and make you feel drowsy. The doctor will implant the ICD and leads and once the leads are inserted, it will be tested to make sure they are in the right place and working properly. You will be given medicine right before testing the leads through your IV to put you to sleep. During the test, small amounts of energy are sent through the leads into the heart muscle causing the heart to contract. This will show us if the leads are functioning appropriately. You will stay overnight after the procedure and typically be discharged the next day.