ICD Implantation
An implantable cardioverter defibrillator is a device under the skin that detects dangerous fast heart rhythms and treats them with rapid pacing or a shock.
What is an ICD?
An implantable cardioverter defibrillator (ICD) looks similar to a pacemaker and is placed in the same way, but it does an extra job. It constantly watches for dangerous fast rhythms from the lower chambers of the heart, such as ventricular tachycardia or ventricular fibrillation, which can cause sudden cardiac arrest. When it detects one, it first tries fast pacing, which you may not feel. If that does not work, it delivers a shock to restore a normal rhythm. An ICD can also pace the heart if it becomes too slow.
Who may be advised an ICD?
- People who have survived a cardiac arrest or a dangerous fast rhythm.
- Some people with a weak heart muscle, as seen in heart failure, whose pumping stays low despite proper medicines.
- Some people with certain inherited heart conditions that raise the risk of these rhythms.
Heart pumping is usually measured with echocardiography before this decision.
The procedure
It is much like pacemaker implantation: local anaesthesia, often with sedation, a small cut below the collarbone, a lead through a vein into the heart, and the device placed in a pocket under the skin. The device is tested before you go home.
What a shock feels like, and what to do
People often describe a shock as a sudden thump or kick in the chest. It is over in a moment.
- One shock and you feel well afterwards: sit down, rest, and inform your cardiologist's clinic soon, as advised.
- More than one shock in a short time, or you feel unwell, have chest pain or are breathless: get emergency help. See emergency signs.
Everyday care
Wound care, arm movement limits, phone distance and airport advice are the same as for a pacemaker. Regular device checks are essential. Driving rules after an ICD or a shock vary, so ask your doctor before driving. Continue your heart medicines; the ICD treats dangerous rhythms but does not replace them.
Whether an ICD is right for you is decided only after examination and your reports. This page is for understanding, not a substitute for consultation.
For understanding only — the right test or treatment is decided after examination.
