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Implantable Cardioverter Defibrillator (ICD)

Cardiac Arrhythmia Ablation

Atrial Fibrillation (AF) Ablation

Atrial Flutter Ablation

Supraventricular Tachycardia (SVT) Ablation

Premature Ventricular Contraction Ablation

Ventricular Tachycardia (VT) Ablation

Cardiac Device Implantation

Pacemaker

Conduction System Pacemaker

Implantable Cardioverter Defibrillator (ICD)

Cardiac Resynchronization Therapy (CRT)

What is an ICD?

A pacemaker is a small device implanted under the skin to help regulate slow heart rhythms (bradycardia). It sends electrical impulses to stimulate the heart when needed to maintain an appropriate heart rate and rhythm.

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 catheter 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 within next day.
  • Inform airport security about your pacemaker, as it may set off metal detectors.
  • Avoid strong magnets and electrical fields, which can interfere with ICD function. 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.

For any concerns after the procedure, do not hesitate to reach out to our office for guidance.