Getting an ICD for tachycardia

Getting an ICD implanted

Getting an ICD Implanted

Illustration showing an ICD in the heart.

The procedure to implant an ICD is minimally invasive, and most people go home within 24 hours. Before the surgery, medication may be given to make you sleepy and comfortable. Generally, the procedure is performed under local anesthesia.

After your procedure, you will be given an ICD identification card. Always carry it with you as it contains important information about the implanted device.

Allow yourself a few weeks to get used to your ICD.

It is important to keep your wound dry for the first few days while it heals. Also avoid wearing tight clothing that could irritate your wound. You should not move the affected shoulder too energetically during the first few days so as not to impair the healing process. Avoid lifting heavy objects. Do not make sweeping movements with your arms, as these can cause undesirable tension on the leads. Consult your doctor in case of specific question.

How is a traditional implantable defibrillator (ICD) system implanted?

A small incision, approximately two to four inches long, will be made in your upper chest area, just below your collarbone.
One or two leads will be guided through a vein into your heart, and the leads will be connected to the defibrillator.
The defibrillator settings will be programmed, and the device will be tested to ensure it is working properly to meet your medical needs.
The defibrillator will be inserted beneath your skin, and the incision in your chest will be closed.

After surgery

You will usually stay in the hospital overnight and go home the next day with instructions on caring for your incision. Your doctor will provide more detailed information, but most individuals can expect to gradually return to their everyday activities shortly after the procedure.

After an ICD system implant, your doctor may want to limit how much you move the arm that is closest to your implant site, for a short time after implant. There may be a slight bulge visible under the skin where the device is located. The leads are very thin and will not be visible.

Each individual’s experience may be different. Talk to your doctor for specific information regarding the implant of an ICD.

Follow up care and monitoring

Your doctor will set follow-up appointments. During such follow-ups, you should not only mention the symptoms that may have occurred during action of the ICD, you should also take this opportunity to ask any questions you may have and talk about your concerns and potential fears.

The follow-up appointments enable the defibrillator to be thoroughly checked. During these check-ups, your doctor may:

Monitor the battery status of the defibrillator
Check the leads to determine how they are working with the defibrillator and your heart
Review and adjust (if needed) your defibrillator settings to ensure they are programmed appropriately for your medical needs

This is done through a programmer, a small computer kept at your doctor’s office. Your doctor will use the programmer to retrieve information stored in your ICD.

In addition to these appointments, you should call or visit your doctor in specific situations:

If the scar becomes red, moist or swells
In case of an alert (beeping tone): your ICD performs self-checks automatically. The beeping tone lets you know that something needs attention from your doctor. It is designed to get your attention, not to alarm you. If you hear a beeping tone, just contact your doctor for instructions. Should you hear a solid, 10 second tone, it simply means your device came into close contact with a strong magnet and you should move away from the magnet
In case of a shock: with current technology, your ICD will deliver a shock only if needed. An inappropriate or unnecessary shock is very unlikely. If tachycardia occurs, the ICD will first try to stop it as gently as possible. If this is not successful, cardioversion or defibrillation will be carried out

Some people are unconscious when their ICD delivers a shock, but others are not and may be aware of what’s happening. Different people perceive the shock from the ICD very differently. The shock can feel like a vigorous or even painful kick in the chest. The muscles in the chest and upper arm may contract so strongly that you jump up in fright. You should not worry about this, as it simply means that the ICD is doing its job. People generally regard this action as necessary and comforting. If you receive a shock, anyone touching you may feel the shock as a muscle spasm or a tingle, although it is unlikely. A shock can be startling, but it will not hurt a person touching you.

Shocks may be uncomfortable. It is normal to be concerned about getting a shock but be reassured this can save your life.

Discuss this with your doctor and he/she will provide a detailed plan of what to do should a shock occur.

An example of a shock plan could be:

If you got one shock, feel ok and don’t have symptoms (i.e you don’t have chest pain, shortness of breath, rapid heartbeat) then you can call your doctor during regular business hours
If you passed out or if you have symptoms like chest pain, shortness of breath, lightheadedness/confusion, dizziness, rapid heartbeat or if you got shocked more than once (within 24 hours), get in touch with your doctor immediately or go to the emergency department. If you are followed remotely by a remote monitoring system, you may be asked to send a transmission right then.

Ask your doctor for their recommended shock plan as this may differ between doctors.

Replacement procedure

The ICD has been developed to let your doctor know when the battery power falls to a low level. As the battery is an inherent component of the pulse generator, the entire pulse generator device must be replaced during a replacement procedure. The surgeon makes an incision over the old scar and removes the old device. The electrodes are fastened securely and, after they have been checked, a new pulse generator device is connected, tested and inserted into the existing skin pocket. The leads only need to be changed in exceptional cases.

Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.