Implantable Cardioverter Defibrillator (ICD)

An ICD consists of a pulse generator and leads (thin, insulated wires). The pulse generator contains the battery, capacitor, and a tiny computer that constantly analyzes the heart’s electrical activity. The leads are threaded through veins into the heart chambers.

This educational video has been chosen by our cardiology team. Suggested or related videos displayed by the video provider are outside of our control and do not represent the views or endorsements of our physicians or clinic.

ICDs are recommended for individuals at high risk of sudden cardiac arrest. This includes:

• Survivors of sudden cardiac arrest due to ventricular fibrillation or ventricular tachycardia.
• Individuals with ventricular tachycardia that has caused fainting (syncope) or significant symptoms.
• Those with a heart condition that increases their risk of life-threatening arrhythmias, such as severe heart failure (ejection fraction ≤35%), certain genetic heart conditions (e.g., long QT syndrome, Brugada syndrome, hypertrophic cardiomyopathy), or prior heart attack with significant heart damage.

The implantation of an ICD is typically performed under local anesthesia with sedation, though general anesthesia may be used in some cases. The procedure usually takes 1-2 hours.

1. Incision: A small incision is made in the upper chest, usually near the left shoulder groove area, to create a pocket for the pulse generator.
2. Lead Insertion: The leads are guided through a vein (subclavian or cephalic) into the heart’s chambers. Fluoroscopy (a type of X-ray) is used to ensure accurate placement of the leads.
3. Connection and Testing: Once the leads are in place, they are connected to the pulse generator. The device is then tested to ensure it can successfully detect and treat abnormal heart rhythms.
4. Device Placement and Closure: The pulse generator is inserted into the pocket under the skin, and the incision is closed with sutures.

This educational video has been chosen by our cardiology team. Suggested or related videos displayed by the video provider are outside of our control and do not represent the views or endorsements of our physicians or clinic.

Living with an ICD requires some adjustments but allows most people to return to a full and active life.

• Follow-up Care: Regular check-ups with your cardiologist are crucial to ensure the ICD is functioning correctly and to monitor battery life. These checks often involve wirelessly interrogating the device.
• Electromagnetic Interference: While most household appliances are safe, some devices with strong electromagnetic fields can potentially interfere with your ICD. It’s generally advised to keep cell phones at least six inches away from the ICD site and to avoid leaning directly over operating motors or large magnets.
• Physical Activity: Most people can resume normal physical activity but contact sports or activities that involve direct blows to the chest should generally be avoided to prevent damage to the device or leads. Discuss specific activity restrictions with your doctor.
• Shocks: An ICD delivers an electrical shock to correct a dangerous heart rhythm. While these shocks can be startling and uncomfortable (often described as a “kick in the chest”), they are typically brief and indicate that the device has successfully intervened to prevent a potentially fatal event. If you receive a shock, you should contact your doctor. If you receive multiple shocks in a short period, seek immediate medical attention.
• Driving: Driving restrictions may apply after ICD implantation, especially if you have had recent episodes of syncope or ventricular arrhythmias. Your doctor will advise you on when it’s safe to resume driving.
• Emotional Support: It’s normal to experience anxiety or fear after receiving an ICD. Support groups, counseling, and open communication with your healthcare team can be very helpful.

This educational video has been chosen by our cardiology team. Suggested or related videos displayed by the video provider are outside of our control and do not represent the views or endorsements of our physicians or clinic.

PRE-PROCEDURE 

• The night before your procedure AND the morning of your procedure please cleanse with an antimicrobial soap, like Dial or Hibiclens (can be purchased over the counter at most pharmacies).
• Nothing to eat or drink (NPO) after midnight the night before your procedure (you may take your morning medications with a small sip of water).
• Please bring a copy of your current medication list to the hospital.

DAY OF PROCEDURE

• Report to the Main Registration Desk at El Camino Hospital
  • El Camino Hospital, 2500 Grant Road, Mountain View CA 94040 | (650) 940-7000
• You will be observed for several hours after the procedure and possibly be admitted for overnight observation. Please bring an overnight bag, just in case.
• If you are kept overnight, you will be discharged from the hospital in the morning the next day. Please arrange a ride home from the hospital.

POST-PROCEDURE 

• You will get detailed instructions upon discharge about wound care.
• You should have a post-op appointment scheduled with your electrophysiologist already, about 7-11 days after your procedure.

If you have any questions, please contact our office at (650) 853-2975, Monday-Friday 8:30am-4:30pm.