Implantable Cardioverter Defibrillator (ICD)

What to Expect During the Procedure

• The procedure is performed under local anesthesia with sedation, meaning you will be awake but comfortable.
• A small incision will be made near the collarbone to create a pocket for the ICD.
• One or more leads (thin wires) will be inserted through a vein into the heart and connected to the ICD.
• The device will be tested to ensure proper function before the incision is closed.
• In some cases, the ICD may be tested by inducing an abnormal heart rhythm to ensure it responds appropriately.
• The procedure typically takes 1 to 2 hours.

Risks Involved

While ICD implantation is a routine and safe procedure, potential risks include:

• Bleeding or bruising at the insertion site.
• Infection at the ICD site, which may require antibiotics or, in rare cases, removal of the device.
• Lead displacement, which may require repositioning in a follow-up procedure.
• Pneumothorax (collapsed lung), a rare complication due to accidental lung puncture during lead placement.
• Cardiac perforation, a rare complication requiring drainage of fluid around the heart. In extremely rare cases, open-heart surgery may be needed.
• Inappropriate shocks, where the ICD delivers shocks when they are not needed, requiring device reprogramming.
• Allergic reaction to anesthesia or contrast dye (if used during the procedure).

What to Expect After the Procedure

• Mild pain, swelling, or bruising at the incision site, which should improve over several days.
• Restricted arm movement on the side of the ICD for 4-6 weeks to allow proper healing.
• Follow-up appointment will be scheduled within a few weeks to check ICD function and incision healing.
• The ICD battery typically lasts 5-10 years, after which a replacement will be required.

Activity and Lifestyle Adjustments

• Avoid lifting heavy objects or raising the arm above shoulder level on the affected side for at least 4-6 weeks.
• Most routine activities, including walking and light exercise, can be resumed the next day.
• Inform airport security about your ICD, as it may set off metal detectors.
• Avoid strong magnets and electrical fields. If your occupation involves exposure to high electrical fields (e.g., arc welding), consult your doctor.
• Driving restrictions may apply if you have received an ICD for high-risk arrhythmias — your doctor will provide specific guidance.

When to Seek Medical Attention

Go to the Emergency Room if you experience:

• Severe pain, redness, swelling, or discharge at the ICD site. (If mild, contact our ICD clinic for an urgent appointment.)
• Persistent dizziness, shortness of breath, or extreme fatigue.
• Sudden swelling of the arm on the side of the ICD.
• Palpitations or an irregular heartbeat.
• If you receive an ICD shock, contact our ICD clinic; however, if you receive multiple shocks or feel unwell, go to the Emergency Department.

Follow-Up Care

• You will have a follow-up visit within 2-6 weeks to check ICD function.
• Routine ICD checks are needed every 6-12 months to monitor battery life and device performance.
• Battery longevity is 6-10 years depending on the type of device and patient factors.