Implantable Cardioverter Defibrillator (ICD) Insertion -- 718.780.7830

An implantable cardioverter defibrillator (ICD) is an electronic device that is implanted in the chest to monitor the heart rate and, if necessary, deliver electrical therapy to restore normal rhythm. An ICD is connected to leads positioned inside the heart. It is usually implanted under the collarbone.

Patient Preparations for an ICD Insertion
Fasting Requirements: You will be instructed not to eat or drink anything after midnight prior to your procedure.
 
Medication Considerations: If you are taking prescription medications, you should discuss with your physician whether you should continue to take your medications on the day of your procedure. Patients who take blood thinners, such as Coumadin®, will be advised by their physicians to stop taking this medication for a period of time prior to their ICD insertion. If you are diabetic, it is important for you to discuss with your physician how to adjust insulin and food intake prior to your procedure.

Overnight Arrangements: You should pack a small bag of essentials since you will be admitted to the medical center and stay overnight.

What to Expect During an ICD Insertion

• An intravenous (IV) tube will be placed into a vein in your arm. You will be given a sedative through the IV to help you relax.
• Your heart rate, rhythm, and blood pressure will be continuously monitored.
• The implantation site will be numbed with a local anesthetic medication.
• An incision is made to create a pocket just below the skin.
• The lead for the ICD is inserted into a vein through the chest incision, then it is threaded to and positioned inside the heart. The Electrophysiology Lab is equipped with special imaging equipment that allows the physician to view the lead as it is threaded towards the heart.
• Once the lead is tested, it is then connected to the ICD unit, which is then programmed to treat your specific type of arrhythmia.
• The incision is closed and covered with bandages.
• The estimated time that it takes for an ICD insertion is one to two hours.
• Prior to discharge, you will be brought to the Electrophysiology Lab and your ICD will be tested. An anesthesiologist will give you medication through your IV to put you to sleep for each test session, and then the electrophysiologist will perform a detailed testing of your ICD.

What to Expect During Recovery from an ICD Insertion

• A nurse will continue to monitor your heart rate, blood pressure, pulses, and insertion site. 
• Upon discharge, most patients require only minimal restrictions of their daily activities for a short period of time, except for driving, which should be avoided until permission is given by your physician.
• It is essential that you see your physician every three months for follow-up visits following an ICD implantation.