An implantable cardioverter defibrillator (ICD) is a small battery-powered device placed under your skin that monitors and treats heart rhythm disorders. If an irregular heartbeat starts, your ICD will send an electric impulse to your heart that will restore your normal heart rhythm.
When you choose UPMC for your ICD, you will receive expert care from some of the region's most experienced cardiologists who treat all types of irregular heart rhythms.
The device is about the size of a stopwatch. It consists of a pulse generator and wires called leads. These leads run from the pulse generator to specific locations in your heart. They are installed through blood vessels without the need for open chest surgery.
If it detects an irregular heartbeat, your ICD will send an electric impulse to your heart that will restore normal rhythm.
There are two types of ICDs:
Pacemakers use electricity to help your heart beat at a normal, steady pace. Although some ICDs provide pacing for your heartbeat, they also monitor your heart for abnormal rhythms. If an abnormal heart rhythm starts, the ICD will deliver a shock to restore a normal heartbeat.
If you have had sudden cardiac arrest or a heart rhythm disorder that puts you at risk of sudden cardiac arrest, your doctor may recommend an ICD. People with heart failure and inherited heart conditions may also benefit from an ICD.
You may be a candidate for an ICD if you:
ICD insertion is safe and effective when it is performed by an experienced electrophysiologist. However, there are risks associated with any medical procedure. Risks of ICD insertion include:
Getting a defibrillator is a life-saving medical intervention. Serious complications are rare. However, because the procedure involves your heart, it is essential to follow all your doctor’s instructions to reduce the risk of problems.
On the day of your ICD procedure, be sure to bring your photo ID and health insurance card(s). Leave valuables such as cash and jewelry at home.
Your doctor will let you know if you will be discharged the same day or stay in the hospital after your procedure. If you are discharged the same day, you will need to arrange for a ride home. If you will be staying in the hospital, you should bring toiletries, a robe, slippers, a cell phone and charger, medications, and a change of clothes.
Your ICD procedure will take 1-2 hours.
After you are positioned on your back on the procedure table, you will be connected to monitors that measure your vital signs (heart rate, blood pressure, breathing rate, and oxygenation level) during the procedure. You will also be connected to an electrocardiogram (ECG or EKG) that records and monitors the electrical activity of your heart using small electrodes that stick to your skin. Your procedure will most likely be performed under monitored anesthesia to keep you comfortable.
After the ICD insertion site is cleansed, your doctor will make a small incision where the ICD lead will be inserted into a blood vessel and guided into the heart. The ICD generator will slip under your skin through the incision (just below your collarbone) after the lead is attached to the generator.
Your provider will perform certain tests to make sure the ICD is working and use the ECG to monitor the results.
After your doctor confirms that your ICD is working properly, your skin incision will be closed and a sterile bandage or dressing will be applied.
After your procedure, you may be taken to the recovery room for observation or returned to your hospital room where a nurse will monitor your vital signs. You should immediately inform your nurse if you feel any chest pain, tightness, or any other pain at the insertion site. The insertion site may be sore or painful and pain medication may be administered if needed.
After a period of bed rest, you may get out of bed without assistance. A nurse will assist you the first time you get up and will check your blood pressure while you are lying in bed, sitting, and standing. You should move slowly when getting up to avoid any dizziness from the period of bed rest. You will be able to eat and drink after you are completely awake.
After you arrive home, it will be important to keep the insertion site clean and dry. You will be given instructions about bathing and showering. You should be able to return to your daily routine within a few days. Your doctor will tell you if you need more time to return to your normal activities. In addition, you should avoid lifting or pulling on anything for 4-6 weeks.
You may be instructed to limit movement of the arm on the side where your ICD was placed. You will be given specific instructions about what to do the first time your ICD delivers a shock. For example, you may be instructed to dial 911 or go to the emergency room in the event of a shock from the ICD. Calming yourself with slow, deep breaths can be helpful if you are anxious after a shock.
Based on the nature of your job, your overall health, and your progress, your doctor will determine how soon you may return to work. You will not be able to drive until your doctor says it’s OK. These limitations will be explained to you if they are applicable to your situation.
You should call your doctor if you are having any unusual symptoms, including:
Your doctor may give you additional or alternate instructions after the procedure, depending on your situation.
After implantation of an ICD, you must be aware of your surroundings and look out for devices that may interfere with its operation. Potentially disruptive devices include those with strong magnetic fields, such as MRI machines. The manufacturers of ICDs have different restrictions depending on your device. You should refer to the company's guidelines for specific instructions regarding your ICD and talk to your doctor if you have questions.
With an ICD, you may live as long as any other person who does not have heart problems. Although you will need routine follow-up care and device maintenance, an ICD will enable you to live a normal life.
Research shows that survival rates at one year after ICD insertion are more than 90 percent, and five-year survival rates are close to 70 percent.
ICDs are more than 95 percent effective at stopping abnormal heart rhythms and are an effective treatment for preventing death from sudden cardiac arrest.
Our heart specialists implant hundreds of ICDs each year and use the latest technology and techniques. If you require additional cardiovascular care, the specialists at UPMC have the skills and experience needed to perform advanced cardiovascular procedures and offer you the latest treatment options.
Last reviewed by a UPMC medical professional on 2024-10-01.
