An implantable cardioverter defibrillator (ICD) can help control and reduce the risk of cardiac arrhythmias

An implantable cardioverter defibrillator (ICD) permanent pacemaker is a small electrical device (about the size of a fifty-cent piece) that is placed slightly below the collarbone under the skin and that can help control and reduce the risk of cardiac arrhythmias. Thin wires called leads are threaded through a large vein in the patient’s chest and anchored into the heart muscle. These wires are then attached to the defibrillator, which senses the heart rhythm and, if necessary, can deliver a small shock that returns the heart into a normal rhythm. ICDs can also store information about cardiac events, which can be studied later by your cardiologist.

Before the procedure:

Have nothing to eat or drink for 12 hours prior to the procedure. Take all medications as ordered with a sip of water. Shower the evening before and the morning of the procedure, using an antibacterial soap. Arrange for someone to drive you to and from Hurley Medical Center. Prepare to remain at the hospital for 24 to 48 hours. Arrive at Hurley two hours prior to your procedure.

Insertion procedure: 

The ICD insertion procedure takes approximately one to two hours. You are taken into Hurley Medical Center’s cardiac catheterization lab and the surgical site is prepared with a two-step cleansing process. It is important that the skin is cleaned to remove bacteria. A large sterile drape is placed over you with a small area cut out for the pacemaker insertion. You are given medication through an IV that will allow you to sleep comfortably but that enables medical staff to wake you when necessary. The area where the cardiologist will insert the device is numbed.

With a needle, your Hurley cardiologist accesses the subclavian vein in your chest and one or more wires is inserted. A small ‘pocket’ is then made under the skin. The leads are advanced through the puncture sites to the top and bottom chambers of the right side of your heart. The leads are then tested and fluoroscopy (a type of x-ray) is used to confirm placement. The leads are then attached to the device and the device will be tested and programmed. A dressing will be placed on the site and will remain for 24 hours.

You will be flat in bed for 24 hours with an arm sling. The arm sling will remain on for 48 to 72 hours. You can resume a regular diet and medications after the procedure. Antibiotics will be administered after the procedure; once you are discharged, you will take these by mouth at home. The ICD will be checked the following day and you will then be discharged.

After discharge:

Take your antibiotics and other medications as ordered by your Hurley physician. Follow up with your physician in two weeks—call ahead for an appointment. If you feel weak or dizzy, call your physician right away.

If you have had an ICD shock and you feel okay, call your physician. If you have had an ICD shock and you feel badly, call 911.

Do not lift anything over five pounds. Do not lift your arm that is on the side of the ICD over your head for one week. Avoid strenuous activity for one week. Have your ICD checked every six months in your doctor’s office. Do not drive until after the initial follow up appointment with your doctor.