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Implantable Defibrillator Insertion

What is an Implantable Cardioverter-Defibrillator?

Implantable cardioverter defibrillatorAn implantable cardioverter defibrillator (ICD) is a small electronic device connected to the heart. It is used to continuously monitor and help regulate potentially fast and life-threatening electrical problems with the heart.  It is about the size of a stopwatch and is implanted under the skin just below the collarbone.  The ICD responds to irregular life-threatening heart rhythms from the lower chambers of the heart with pacing that corrects a fast rhythm and promotes a normal heartbeat, or a shock (defibrillation) that resets the heart rhythm to prevent sudden cardiac arrest. An ICD also records and stores information about your heart rhythm and therapies delivered by the ICD for your doctor to review.

Most people are unaware when the ICD is pacing the heart. But, a defibrillation shock is described by many as feeling like a "kick in the chest."  The ICD can also be programmed to work as a basic pacemaker as needed. Sometimes after a shock is delivered, the heart may beat too slowly. The ICD has a "back-up" pacemaker, which can stimulate the heart to beat faster until the normal heart rhythm returns. The ICD can act as a pacemaker any time the heart rate drops below a preset rate.


What can I expect during the procedure?

For most people undergoing an ICD implantation, it is done under conscious sedation with a light sedative and a numbing medication at the site of insertion.  An incision will be made just below the collar bone to make a "pocket" for the ICD device to go into.  Up to 3 leads (or wires) will be placed through the incision and into your heart's atrium or ventricle.  Once the leads are in position, they are connected to the ICD.  The device will be tested prior to ending the procedure by making your heart beat quickly and will receive a shock from your new ICD to stop it.  If successful, the incision is closed and you return to the cardiac recovery area.  This entire process takes anywhere from 30 to 90 minutes.  

Who offers these procedures?