An implantable cardioverter defibrillator (ICD) is a small, battery-powered device placed in the chest to detect and stop certain abnormal heart rhythms.

This is the second blog in our “deep dive” into cardiac devices and how they can help you. We covered pacemakers yesterday and will focus on event recorders tomorrow. Today is about the life-saving technology of ICDs.

What is a defibrillator?

An implantable cardioverter defibrillator (ICD) is a small, battery-powered device placed in the chest to detect and stop certain abnormal heart rhythms. If it senses these life-threatening heart rhythms, it will send an electrical shock to reset the heart.

Why would someone need an ICD?

Your cardiologist may recommend an ICD if you have ever had a life-threatening heart rhythm called ventricular tachycardia or ventricular fibrillation, or if you have survived a cardiac arrest. They may also recommend an ICD if the pumping function (ejection fraction) of your heart is weak or if you have other certain rare heart disorders which place you at higher risk for these life-threatening heart rhythms.

How does it help me?

It can save your life. In ventricular tachycardia and ventricular fibrillation, the main pumping chambers in your heart contract too fast or simply vibrate, pumping little or no blood. This can lead to cardiac arrest, which can be fatal in minutes. The ICD senses when one of these life-threatening events starts and delivers an electric shock to restart your heart. It’s like having an AED with you 24/7, ready to deliver a life-saving shock anywhere you may be, anytime you may need it.

What is the procedure like?

We perform pacemaker insertions in the Cardiac Cath Lab at St. Mary’s Hospital. Most patients need only moderate sedation but some may undergo general anesthesia. The left upper chest area is numbed and a small incision is made. A wire (or multiple wires, depending on your condition) is placed into the heart in specific areas. High resolution imaging is used to ensure proper placement. Those wires, or leads, are then connected to the device, which is placed under the skin and the incision is closed. Complications are rare; your cardiologist will talk with you about them before the procedure. You can expect to go home after a few hours in our recovery room.

What should I do after the procedure?

After the procedure, you cannot drive or shower for one week. For one month, you should not lift your left arm (the same side as the device) straight up. For most patients, there are no restrictions after the first month. If you are frequently around large machinery, engines, or arc welding, you should let your cardiologist know before the procedure. Monitor the site for signs of infection such as redness or pus. Follow up regularly with your cardiologist and device specialist to monitor the device. Also, if you ever need an MRI, be sure the doctor and technologist know you have a cardiac device.

How long does the battery last?

The battery typically lasts 5-10 years. Battery life is monitored, and when it is time to change the battery, it is done with a minor outpatient procedure.

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Kristin Lawson, NP