Implantable Cardiac Defribrillator - Cardiovascular Associates of Maryland
What is an implantable cardiac defibrillator?
Your Cardiologist/Electrophysiologist may have referred you for an
implantable cardiac defibrillator. These devices are usually indicated
for patients at risk for lethal fast heart rates referred to as
ventricular tachycardia (VT), ventricular fibrillation (VF), cardiac
arrest, sudden cardiac death, or ventricular tachyarrhythmias.
Implantable cardiac defibrillators (ICD) are also often referred to as an AICD, Defibrillator or CRM device. Features include:
- Consists of a metal device which houses the battery/electronics
and one, two or three leads which either pace or shock/defibrillate the
heart.
- The leads are placed in various chambers within the heart.
- The ICD will shock or defibrillate your heart if you have a lethal ventricular tachyarrhythmia or sudden cardiac arrest.
- All ICD’s are also full functioning pacemakers and provide back-up pacing.
- The devices are typically two to three inches in diameter and ½” thick.
Indications for ICD’s
ICD’s are most commonly placed in patients who are deemed to be high risk patients for sudden cardiac arrest. The majority of these patients have ICD’s implanted prior to their first event. Most patients have weak hearts due to either prior heart attacks, or may have weak heart muscle for various reasons.
Some patients may require ICD’s if they have a condition
referred to as Hypertrophic Cardiomyopathy or long QT syndrome. This is
a congenital disorder and typically affects younger patients.
Implantation
Implanting an ICD includes the following:
- Making a 2 inch incision in the chest region.
- Surgery takes approximately 90 minutes for one and two lead systems.
- May take up to three hours for three lead systems.
- Anesthesia: Local and conscious sedation (twilight).
- The leads are threaded via either the subclavian/axillary/cephalic vein to the heart.
- Overnight stay.
- 1-2% risk of complications.
After Surgery
After the ICD is implanted the dressings should remain on for up to four days. You can shower once the dressing is removed, but tub bath or sponge bath until then. There should be no lifting the affected side above the shoulder for one month, and no lifting greater than five pounds with the affected side for one month.
Living with an ICD
We encourage patients to be very active once the ICD has healed. You should carry the ICD ID card with you at all times and inform any medical professional that you have an ICD. You should also inform security when walking through a metal detector that you
have an ICD. Walking through the metal detector will not harm the ICD.
ICD’s are not compatible with MRI scanners. You may have X-rays, CT scans and stress tests. You may also use a microwave with an ICD.
Following Up After Surgery
ICD’s should be followed up either in our clinic or at your cardiologist's clinic every three months. Most ICD’s last 4-6 years, however actual longevity may vary based on usage.