Implantable Cardioverter-Defibrillator (ICD)

Summary

Dr. Kevin Thomas, a cardiac electrophysiologist at Norton Heart and Vascular Institute, explains the procedure of implanting an Implantable Cardioverter Defibrillator (ICD), a life-saving device for patients at risk of life-threatening heart rhythms. The ICD monitors the heart continuously and delivers an electrical pulse to restore a normal rhythm in case of a cardiac arrest. The procedure involves inserting leads into the heart and placing the generator under the skin, and is typically completed in 1-2 hours. Post-procedure care includes monitoring, medication, and follow-up instructions to ensure proper recovery and device maintenance.

Takeaways

• 😀 ICD (Implantable Cardioverter Defibrillator) is a life-saving device used to treat dangerous heart rhythms like ventricular tachycardia and ventricular fibrillation.
• 😀 ICD monitors your heart 24/7 and delivers an electrical pulse to restore normal heart rhythm if it detects a life-threatening irregularity.
• 😀 Ventricular tachycardia and ventricular fibrillation can lead to sudden cardiac arrest, which can be fatal without immediate treatment.
• 😀 The ICD is composed of a small generator (battery and circuitry) and leads (wires placed in the heart).
• 😀 The ICD implantation procedure takes 1-2 hours and is performed in the electrophysiology lab under sedation or local anesthesia.
• 😀 A small incision is made near the collarbone to create a pocket for the generator, and leads are inserted into veins and guided to the heart.
• 😀 After the leads are positioned correctly, they are tested to ensure proper sensing of heart signals and are connected to the generator.
• 😀 Once the procedure is complete, the incision is closed, and the patient is monitored in a recovery area for several hours.
• 😀 Most patients can go home the same day, though some may stay overnight for monitoring and pain management.
• 😀 Post-procedure care includes instructions on wound care, activity guidelines, medication changes, and follow-up appointments.
• 😀 Patients are encouraged to reach out to their doctor's office with any questions about the procedure or recovery process.

Q & A

What is an Implantable Cardioverter Defibrillator (ICD)?

An ICD is a medical device designed to monitor and treat life-threatening abnormal heart rhythms, such as ventricular tachycardia or ventricular fibrillation, by delivering a life-saving electrical shock to restore normal heart rhythm.

Who might need an ICD?

An ICD may be recommended for patients who have experienced or are at an increased risk for life-threatening abnormal heart rhythms, particularly those that can lead to sudden cardiac arrest, such as ventricular tachycardia or ventricular fibrillation.

How does an ICD work?

The ICD monitors the heart's rhythm 24/7. If it detects a dangerous rhythm, it sends an electrical pulse to the heart to reset its normal rhythm, a process known as defibrillation, allowing the heart to resume pumping blood properly.

What are the components of an ICD?

An ICD consists of two main components: the generator, a small metal case containing the battery and circuitry, and the leads, which are flexible, insulated wires placed in the heart to detect and deliver therapy.

What determines how many leads an ICD will have?

The number of leads an ICD has depends on the patient's specific condition. It may have one, two, or three leads, depending on the complexity of the heart condition being treated.

What happens during the ICD implantation procedure?

The ICD implantation procedure typically lasts between one to two hours. It involves making a small incision near the collarbone, placing the generator under the skin, and inserting leads into veins and advancing them to the heart under X-ray guidance. The leads are then tested, connected to the generator, and the incision is closed.

Will I be awake during the ICD procedure?

You will be given medications intravenously to make you sleepy or sedated, but you will remain awake during the procedure. Local anesthesia will be used to numb the area where the incision will be made.

What should I expect after the ICD procedure?

After the procedure, you'll be moved to a recovery area where your heart rate and blood pressure will be monitored. You may be able to go home the same day, but in some cases, your doctor may choose to keep you overnight for monitoring and pain management.

What kind of care will I need after the procedure?

You will receive instructions on how to care for yourself after the procedure, including guidance on medication changes, wound care, activity restrictions, and device maintenance. A follow-up schedule will also be provided.

How long does the ICD implantation procedure take?

The ICD implantation procedure typically takes between one to two hours, depending on the specifics of the patient's condition and the complexity of the implantation.