An implantable cardioverter defibrillator (ICD) or subcutaneous implantable cardioverter defibrillator (SICD) is a small, battery-operated device. The ICD can be permanently placed inside the chest or just under the skin to monitor heart rate and rhythm to detect any rapid and/or irregular heart rhythms (arrhythmias). When the ICD detects a rapid heart rate, it delivers energy to the heart, converting it back to a regular rhythm and has the ability to pace the heart when needed. Implantable cardiac defibrillators are used for those at risk of sudden cardiac death, who have cardiomyopathy, or an abnormal heart rhythm called ventricular tachycardia.
How an Implantable Cardioverter Defibrillator (ICD) Is Inserted
Inserting an implantable cardioverter defibrillator is usually performed during a minimally invasive surgical procedure in a cardiovascular catheterization laboratory. A local anesthesia is used to numb the treatment area. An IV (intravenous line) into the arm or hand will provide medication to make the procedure as comfortable as possible. The ICD is inserted into the chest, through a small incision which forms a pocket to hold it in place. From a small incision under the collarbone, the leads are guided into a large vein that connects to the heart; this process is aided by viewing X-ray images on a fluoroscopy machine. One end of the lead is attached to the heart wall while the other end is attached to the implantable cardioverter defibrillator.
The S-ICD System is implanted just under the skin without accessing the veins. Next, a small incision is made on the left side of the chest, next to the rib cage. A pocket or pouch is formed under the skin, where the S-ICD System pulse generator will be placed. Two small incisions will be made slightly to the left of the breastbone to allow the electrode to be placed under the skin.The electrode is then attached to the S-ICD System pulse generator. The S-ICD system’s purpose is to shock the heart out of life threatening rhythms, however does not have pacing capabilities.
Some ICD inserts are performed as open-heart surgery under general anesthesia.
We also provide surgical services to extract ICDs and leads of infected or malfunctioning devices.
Patient Guides: Preparing for Cardiac and Peripheral Catheterization