An implantable cardioverter defibrillator or ICD is an electronic device that is implanted
in a fashion similar to a pacemaker. It is bigger than the simpler pacemaker, about the size of a beeper; and it performs several functions. It monitors your
heart rhythm continuously; it paces your heart when it's too slow; and if you develop a sudden abnormal fast heart rhythm, it can either deliver rapid electrical
pulses to terminate the arrhythmia, or it can deliver a shock to the inside of your heart to stop the abnormal rhythm. These advanced devices are implanted if you
have already experienced a serious ventricular arrhythmia or if your doctor has
determined that you are likely to develop these rhythm disturbances in the future.
ICD's are implanted under local anesthetic by an electrophysiologist, a cardiologist specialized in the treatment of arrhythmias, sometimes immediately after an
electrophysiology study. An incision is made below your left or right collarbone and a pocket is created for the device under
the skin. The device, much like a pacemaker, consists of a pulse generator (where the battery and electronics are housed) and one or more leads that connect the
device to the heart through a vein. X-ray is used to guide the leads into their proper place within the heart. Testing of the leads of an ICD at the time of
implant includes electrically stimulating the heart and intentionally creating the arrhythmia. The purpose of this test is to ensure that your ICD will reliably
correct an abnormal rhythm. The ICD is programmed very carefully to meet your specific needs. The incision is then closed. During the implant you will receive
sedative medicines to keep you comfortable. The implant procedure typically takes between one and two hours to complete.
After discharge from the hospital, the function of your ICD will be closely monitored periodically by your cardiologist and an ICD nurse specialist. If an ICD
implantation is ordered for you by your doctor, you will receive more detailed information and instructions when the procedure is scheduled.
