Procedures
What Is an ICD?
Implantable cardioverter defibrillators (ICD) are devices that save the lives of patients at high risk of ventricular tachycardia or fibrillation.\nA tachycardia is a very fast heartbeat of more than 100 beats per minute. During tachycardia of the ventricles – the two main chambers of the heart – the heart beats too fast to pump sufficient blood to the body. This is life threatening and can lead to ventricular fibrillation. During ventricular fibrillation, the heart chambers can no longer contract. This causes cardiac arrest within minutes – the heart suddenly and unexpectedly stops beating – and is one of the most common causes of sudden cardiac death. The only way to stop ventricular fibrillation is defibrillation. An electric shock, defibrillation disrupts the tachycardia, allowing the heart to restart its activity in a normal rhythm. People who do not have an ICD can be defibrillated externally in an emergency. ICDs offer patients at high risk of ventricular tachycardia or fibrillation the best protection against these life-threatening events. An implantable defibrillator works around the clock to automatically detect irregularities in your heartbeat and deliver the appropriate treatment. It stops life-threatening tachycardia and fibrillation with relatively weak and painless stimulation therapy or electrical shocks. Surgery is necessary to implant an ICD.
Before Surgery
Your physician will give you detailed instructions about how to prepare for the surgery. Usually, you will be advised to stop taking blood-thinning medication several days before surgery. If you take other medication regularly, ask your physician if you should continue taking the medication before your procedure. In addition, you should not eat for about 12 hours prior to the implantation.
ICD Implantation
The procedure to implant an ICD is relatively simple. It is not open-heart surgery. You will receive antibiotics to reduce the risk of infection. The intervention will be performed under local anesthesia, and sometimes, short-term sedation.
After preparing the incision site, the surgeon will make a small cut in your upper chest, well below your shoulder. The surgeon will insert wires called leads that deliver energy to the heart into a major vein near your collarbone. Using X-ray for visibility, the surgeon will guide the leads through your veins and place them at the correct locations in your heart. Then, the surgeon will implant the ICD in a pocket created at the incision beneath the skin. The surgeon will connect the leads to the defibrillator and program it for your specific medical needs. After a test to ensure that the ICD is working correctly, the surgeon will close the incision with a few stitches.
After the Implantation
Usually, you will stay in the hospital for one to two days after the implantation. Listen carefully to your physician and follow their instructions.
At home, monitor how the incision is healing. Your arm’s range of motion will probably be limited until the wound is completely healed. In some patients, the ICD forms a small, visible bulge underneath the skin. Most patients get used to it quickly and soon cease to notice it.
Magnetic fields and electromagnetic radiation can influence your ICD’s functionality. Please ask your physician about which kinds of devices may affect your ICD and how to avoid them, and consult the patient brochure you receive from your physician. New BIOTRONIK ICDs include ProMRI® technology. Check whether your device is approved for magnetic resonance imaging (MRIs) here. Always carry your patient identification card on you. In the case of a medical emergency, it prevents physicians from running tests and doing procedures that will interfere with your device.