Implantable Cardiac Defibrillator (ICD)

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Implantable Cardiac Defibrillator (ICD)

An implantable cardioverter defibrillator (ICD) is a device similar to a pacemaker, which is usually placed under the skin below your collarbone.

ICDs are often used as a preventative treatment for people thought to be at risk of cardiac arrest at some point in the future.

 ICD senses if the heart is beating at a potentially dangerous abnormal rate and delivers an electrical shock to the heart that essentially “reboots” it to return to a normal rhythm and start pumping again.

Most modern ICDs have three main functions:

  •     If your heart rhythm is too slow, the device can give your heart extra support by working as a normal pacemaker (anti-bradycardia pacing).
  •     If your heart beats too fast, the ICD can return your heart back to a normal rhythm (anti-tachycardia pacing or ATP).
  •     If the anti-tachycardia pacing does not bring your heart back to a normal rhythm, or if the ICD senses a faster, dangerous rhythm called ventricular fibrillation, the ICD can then give a shock (defibrillation) to the heart to restore normal rhythm.

What does the procedure involve?

In most cases, implantable cardioverter defibrillators (ICDs) are fitted transvenously, along a vein. But they can also be fitted under the skin (subcutaneously). Subcutaneous implantation is either carried out using general anaesthesia, or with local anaesthesia and sedation.

  1.   During the procedure, a pocket will be created in the left side of the chest where the ICD will be positioned.
  2.   The pacing lead and electrodes are also placed under the skin along the breastbone and are connected to the device.
  3.   After the cuts have been closed, the sensing, pacing and recording functions of the ICD will be tested and adjusted.

Fitting an ICD can take 1 to 3 hours depending on the type of device you’re having fitted. An overnight stay in the hospital is often, although not always, required.