Implantable cardioverter defibrillator

Prior to the procedure to implant your ICD, you’ll receive personalized guidance to prepare. This may include:

• Not eating or drinking after midnight the night before the procedure
• Any medications you may need to stop taking
• Your preference for placing the ICD on either your right or left side
• Answering your questions and concerns

Usually, the procedure to implant your ICD will take about two to three hours. On the day of the procedure, you’ll be admitted to the hospital. The area of skin where your ICD will be implanted will be washed and may be shaved. You'll receive medication so you won't feel any pain and to help you sleep through all or part of the procedure.

To begin, our board-certified electrophysiologist will make an incision in your skin below your collarbone. For an abdominal implant, we’ll also make a second incision below your rib cage.

Using X-ray technology, we’ll gently guide the lead through the incision into a vein in your upper chest to your heart. For an abdominal implant, we’ll thread the other end of the lead under the skin from your chest to your abdomen.

To custom program the ICD to best treat your condition, we’ll optimize the generator’s settings. Then, after attaching the leads and placing the generator under your skin or muscle, we’ll close the incision.

Sometimes, you also may need a patch electrode to help the ICD do its job. To do this, we’ll make another incision and place the patch under the skin or muscle near your heart. We’ll connect the patch to the generator with a lead.

Although uncommon, your ICD may be implanted during open-chest surgery. We may do this while correcting for another heart problem or if the leads cannot be placed in your veins. If this happens, we’ll attach the leads to the outside of the heart and place the generator in your abdomen.

You’ll likely stay in the hospital for a day or two to make sure your ICD is working properly. We’ll regularly check your pulse, blood pressure and incision, and make sure you’re as comfortable as possible.

To allow the leads to secure themselves inside your vein and heart, you shouldn’t lift your arm above your shoulder on the ICD side. You may feel some stiffness and pain in the incision area and we’ll give you medication to relieve it.

Before going home, you may have a chest X-ray and we may adjust your ICD's settings from outside your body.

When you return home, you’ll be able to continue with most of your daily activities. You’ll need to take it easy for about a month to keep from pulling the leads out of place. This includes no heavy lifting, running or playing contact sports until your doctor says it's safe.

We’ll ask you to take your temperature every day for a week and check your incision for signs of infection. You should contact your doctor if you have a fever or redness, swelling, drainage or pain at the incision site or if the area is warm to the touch.

For a few weeks, you may feel numbness in the area surrounding your ICD. This is totally normal. If you have sutures or staples, we’ll remove them during a follow-up visit. Your incision should heal completely within a month.

Although it won't be noticeable under your clothes, you may feel and see a small bump under your skin at the ICD implant site. Avoid rubbing or playing with it.

Continue taking your medication as your doctor recommends. Your driving may be restricted due to your heart rhythm problem.

You’ll want to schedule regular visits with your doctor to make sure your ICD is working properly and to check its recordings of any arrhythmia events and corrections. If needed, we’ll adjust any settings from outside your body.

Your ICD batteries will need to be replaced every three to seven years, but don't worry, your battery won't run down unexpectedly. When it’s time to change the battery, we’ll replace the generator during a procedure that’s similar but shorter than the first one. Your leads may also need to be replaced periodically.

If you have an arrhythmia event, you may experience your usual symptoms like palpitations, fluttering or feeling dizzy, lightheaded, faint, weak, warm or flushed. Find a place to sit or lie down and elevate your feet if possible. Ask someone to stay with you for about 15 minutes. You can rely on your ICD to provide the proper treatment, but you may not always feel it working. Other times you may a light thump or kick to the chest.

You’ll seldom need additional medical treatment after an event, but always let your doctor know. If you feel OK after an event, it is not an emergency and contacting them during regular business hours is fine.

If your event is more serious, call for emergency care immediately.

Call 911 if you:

• Still feel symptoms after a shock
• Feel three or more shocks in a row
• Have symptoms that don't go away and you feel no shock
• Are unconscious for more than 30 seconds