An implantable cardioverter defibrillator (ICD) is a tiny medical device that uses a battery to detect and stop arrhythmias. The device is placed in the chest and it continuously checks the heartbeat to be then used as a cardiac therapy device.
When irregularities are detected in the heart rhythm, the ICD delivers shocks to regulate the heartbeat; this process is called defibrillation.
Components of an ICD
- The pulse generator contains an electric circuit and a battery that reads the heart's pulse.
- Leads are connected to the veins throughout the heart and the device.
- An in-build pacemaker is usually part of the ICD when the heartbeats are slow or fast (the heart needs pacing).
The Invasive Cardiology Department at Aster is one of the best in the field of invasive procedures and diagnostics. With superior quality testing equipment, Aster is known to provide the best management protocols and services.
FAQs
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Is an ICD the same as a pacemaker?
Both the devices are different; an ICD keeps track of the heartbeat, and the pacemaker is used to prevent a dangerously slow heartbeat.
Does an ICD prevent a heart attack?
An ICD does not treat blockage in the coronary arteries but treats abnormal heart rhythms.
What is the battery life of an ICD?
The battery of an ICD has a lifespan of around 7 years, but a regular check-up needs to be done with the doctor to ensure the ICD's status.
What does the ICD shock feel like?
It is a high-energy shock that feels like a blow to the chest and is painful.
Can an ICD function as a pacemaker?
An ICD can function as a pacemaker as the ICD has a pacemaker as one of its components.
Who implants the ICD?
An interventional cardiologist implants the ICD.
Can the patient eat before going for the ICD implantation surgery?
Apart from water, the patient is not allowed to have any meal before going for the surgery.
How often does a patient with an ICD need an evaluation?
A regular evaluation should be conducted to evaluate the battery's status.
Advanced Technology & Facilities
Types of ICD
There are two types of ICDs:
1. A traditional ICD is placed in the chest with leads (wire) connected to the heart.
2. A subcutaneous ICD (S-ICD) is placed under the skin on the side of the chest below the armpit, and the sensor (electrode) runs along the breastbone and does not touch the heart.
Which patients are candidates for ICD?
- Patients with damaged heart muscle and heart failure as this can lead to irregular heart rhythm (arrhythmia)
- Patients who have experienced and recovered from abnormal heart rhythms as they may reencounter the episode
- Patients with prolonged QT syndrome due to Brugada syndrome (inherited arrhythmia)
- Patients with conditions such as hypertrophic cardiomyopathy (abnormal thickening of cardiac muscle) and previous myocardial infarction (heart attack)
The doctor will need to examine the patient and advise accordingly for the implantation of a defibrillator.
Procedure for ICD implantation
The cardiologist will perform an electrogram to determine the health of the patient's heart to know if the heart has the required health to undergo the implantation.
Routine blood and urine tests will determine the patient's overall health.
The healthcare provider should also be informed of the patient's ailments and the medication taken, mainly if any anticoagulants are prescribed for a condition.
If any allergies, especially to dyes, are known to the patient, the healthcare providers must be informed during the routine check-up.
What happens when the ICD is being implanted?
- The implantation of an ICD is carried out as a surgical procedure.
- The procedure adopted depends on the health of the patient and the type of ICD required.
- Usually, general and local anesthesia is used to make the patient relax and go to sleep while performing the implant and numb the area where the incision will be made.
- The incision is made around the collarbone but can also be made in the chest or the abdomen (belly).
- The subclavian vein is where the wires are inserted in the heart chambers.
- ICD is pouched and placed under the skin.
- The lead and the ICD must be connected to the heart and tested.
- The implant has to be tested to determine if it works properly before closing the incision and sending the patient for recovery.
What happens after the procedure?
A chest x-ray is done during the surgery to check if the lungs and the system are stable.
When taken into the recovery room, the nurse monitors the vital signs. When the anesthesia has worn out, the patient must eat and drink plenty of water.
The patient may feel sore and tired and experience pain around the incision area. In that case, they can inform a healthcare provider and pain medication can be suggested to make the patient more comfortable.
Depending on the health of the patient and the procedure adopted, the patient's discharge can be a day after the surgery. A few patients may have to stay in the hospital for a few days.
Before getting a discharge, the healthcare provider must test the ICD system again.
Risks
Any surgery will have risks, but the possible hazards of this surgery include the following:
- Incision infection
- Blood clot formation
- Injury to the heart or the lungs
- Arrhythmias
- Allergy to anesthesia
- Stroke
Home care
The patient has to make a few lifestyle modifications to their everyday routine to minimize the duration for recovery.
The following advices need to be implemented:
- Care at the incision site to avoid infection by keeping it clean and dry.
- The patient can resume regular diet unless the doctor restricts it.
- Heavy lifting should be minimal for a few weeks after the surgery.
- Driving is resumed once the doctor gives the go-ahead.
- Ask the doctor when the patient can resume work.
- Instructions will be given by the doctor when the ICD delivers the first shock and what has to be done.
- The doctor must be informed immediately of fever, chest pain, throbbing, swelling, or redness around the incision site and if the ICD device feels loose.
The patient should always have an ID card stating they have an ICD and must consult a doctor while starting any activity or using any machinery for safety.
