Implantable Cardioverter Defibrillator (ICD) Insertion

Overview

An implantable cardioverter defibrillator, or ICD, is a small battery powered device surgically implanted in your chest. An ICD continuously monitors your heart rhythm and checks for irregularities. If the ICD detects an abnormal heartbeat, the device can send electrical shocks to your heart to fix an abnormal heart rhythm. Newer ICDs may have multiple functions, including the ability to serve as a pacemaker that would stimulate the heart to beat if the heart rate is detected to be too slow.

Candidates for ICD insertion

Your cardiologist may recommend you have an ICD inserted if you have:

• Arrhythmia (irregular heartbeat)
• Coronary artery disease
• Genetic heart defect
• Thickened or enlarged heart muscle
• Ventricular fibrillation (irregular heartbeat that prevents your heart from sending enough blood to your body)
• Ventricular tachycardia (very fast heartbeat)

Preparing for an ICD insertion

Before undergoing the ICD insertion, your cardiologist will perform several tests to ensure that you and your heart are healthy enough for surgery. These tests may include electrocardiogram (ECG), Holter monitoring or electrophysiology study (EPS).

On the night before your procedure, you won’t be able to eat or drink anything after midnight. Your doctor will give you specific directions on whether you need to stop taking any of your medications, such as blood thinners.

Expectations during an ICD insertion

You will undergo the ICD insertion in the hospital, and you will be under sedation to help you relax. You will receive local anesthesia, which numbs the area where your surgeon makes an incision for the procedure. Depending on your situation, you may be under general anesthesia, meaning that you’re fully asleep.

Your surgeon begins by making a small incision near your collarbone. The surgeon inserts wires through the incision and threads them to your heart. Once in place, your surgeon places the ICD under the skin of your chest and closes the incision with stitches and a bandage. Your surgeon will test the device and program it to your specific heart needs.

Recovery from ICD insertion

You can expect to remain in recovery for a few hours while the effects of anesthesia and sedation wear off. During this time, we monitor you closely. In most cases, you will be able to return home the same day of the insertion. 

Once you are home, you will need to take it easy while you recover. Specifically, you should avoid raising your left arm above your shoulder for at least two weeks. You will not be able to drive during this time. You may be prescribed prescription pain medication to help manage post-surgical pain. In some cases, taking over-the-counter pain medication is enough to manage pain.