An implantable cardioverter defibrillator (ICD) is a small device that’s placed in the chest or abdomen. Doctors use the device to help treat irregular heartbeats calledarrhythmias (ah-RITH-me-ahs).
An ICD uses electrical pulses or shocks to help control life-threatening arrhythmias, especially those that can cause sudden cardiac arrest (SCA).
SCA is a condition in which the heart suddenly stops beating. If the heart stops beating, blood stops flowing to the brain and other vital organs. SCA usually causes death if it’s not treated within minutes.
How Does a Pacemaker Work?
An implantable cardioverter defibrillator (ICD) has wires with electrodes on the ends that connect to one or more of your heart’s chambers. These wires carry the electrical signals from your heart to a small computer in the ICD. The computer monitors your heart rhythm.If the ICD detects an irregular rhythm,
it sends low-energy electrical pulses to prompt your heart to beat at a normal rate. If the low-energy pulses restore your heart’s normal rhythm, you might avoid the high-energy pulses or shocks of the defibrillator (which can be painful).Single-chamber ICDs have a wire that goes to either the right atrium or right ventricle. The wire senses electrical activity and corrects faulty electrical signaling within that chamber.Dual-chamber ICDs have wires that go to both an atrium and a ventricle. These ICDs provide low-energy pulses to either or both chambers. Some dual-chamber ICDs have three wires. They go to an atrium and both ventricles.
The wires on an ICD connect to a small metal box implanted in your chest or abdomen. The box contains a battery, pulse generator, and small computer. When the computer detects irregular heartbeats, it triggers the ICD’s pulse generator to send electrical pulses. Wires carry these pulses to the heart.
The ICD also can record the heart’s electrical activity and heart rhythms. The recordings can help your doctor fine-tune the programming of your ICD so it works better to correct irregular heartbeats.The type of ICD you get is based on your heart’s pumping abilities, structural defects, and the type of irregular heartbeats you’ve had. Your ICD will be programmed to respond to the type of arrhythmia you’re most likely to have
What To Expect During Implantable Cardioverter Defibrillator Surgery
Placing an implantable cardioverter defibrillator (ICD) requires minor surgery, which usually is done in a hospital. You’ll be given medicine right before the surgery that will help you relax and might make you fall asleep.
Your doctor will give you medicine to numb the area where he or she will put the ICD. He or she also may give you antibiotics to prevent infections.
First, your doctor will thread the ICD wires through a vein to the correct place in your heart. An x-ray “movie” of the wires as they pass through your vein and into your heart will help your doctor place them.
Once the wires are in place, your doctor will make a small cut into the skin of your chest or abdomen. He or she will then slip the ICD’s small metal box through the cut and just under your skin. The box contains the battery, pulse generator, and computer.
Once the ICD is in place, your doctor will test it. You’ll be given medicine to help you sleep during this testing so you don’t feel any electrical pulses. Then your doctor will sew up the cut. The entire surgery takes a few hours.
What to Expect After Cardioverter Defibrillator Surgery
Expect to stay in the hospital 1–2 days after implantable cardioverter defibrillator (ICD) surgery. This allows your health care team to check your heartbeat and make sure your ICD is working well.
You’ll need to arrange for a ride home from the hospital because you won’t be able to drive for at least a week while you recover from the surgery.
For a few days to weeks after the surgery, you may have pain, swelling, or tenderness in the area where your ICD was placed. The pain usually is mild, and over-the-counter medicines can help relieve it. Talk to your doctor before taking any pain medicines.
Your doctor may ask you to avoid high-impact activities and heavy lifting for about a month after ICD surgery. Most people return to their normal activities within a few days of having the surgery.