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Automatic Cardioverter Defibrillator Implantation


Why is this procedure done?


An automatic implantable cardioverter-defibrillator has a pacemaker and a defibrillator. It may also be called an ICD. The pacemaker can speed up the heartbeat if it gets too slow or can keep the heartbeat at the right pace. A defibrillator is a device that watches your heart beat and treats problems with the heartbeat. The defibrillator corrects any fast, dangerous heartbeats by giving a small amount of electricity to the heart. ‚  
This procedure is done in people with: ‚  
  • Very slow heartbeats. This is bradycardia.
  • Very fast heartbeats. This is tachycardia.
  • People who have had dangerous, fast heartbeats before and may have them again.
  • People who are at high risk for sudden cardiac arrest. Sudden cardiac arrest most often causes death if not treated within minutes.


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What will the results be?


This can help prevent death caused by a very fast or very slow heartbeat. ‚  

What happens before the procedure?


  • Your doctor will take your history. Talk to the doctor about:
    • All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
    • Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
    • When you need to stop eating or drinking before your procedure.
  • Your doctor will do an exam and may order:
    • Lab tests
    • ECG

What happens during the procedure?


  • Once you are in the operating room, you will be given a drug to make you sleepy. It will also help you stay pain free during the surgery. The staff will put an I.V. in your arm to give you fluids and drugs.
  • The doctor will make a cut below your collarbone. A wire will be put into a vein until it reaches the heart. An x-ray monitor will be used to watch the movement of the wire. The signals between the heart and the ICD will be carried on this wire.
  • The doctor will make a pocket under your skin in the area where the cut is done. The ICD will be placed in the pocket.
  • Once the ICD is working the right way and in the right place, your cut will be closed with stitches.
  • The procedure will take about 1 to 3 hours.

What happens after the procedure?


  • You will go to the Recovery Room after surgery. Your doctor will order an ECG.
  • You will be given antibiotic drugs during the procedure and for a short period of time after surgery.
  • You will need to keep your arm in a sling for a few days.
  • Do not lift your arm above your chest while the site is healing. This could cause the wires to move.
  • The day after your device is implanted you will get an x-ray done to make sure the device is correctly in place.
  • You will feel pain or stiffness in the area where the cut is done. Your doctor will give drugs for this.
  • You may stay at the hospital for 1 to 3 days after the procedure.

What drugs may be needed?


The doctor may order drugs to: ‚  
  • Help with pain
  • Prevent infection

What problems could happen?


  • Infection
  • Bleeding
  • Bruising
  • Failure of the device to work the right way

Where can I learn more?


Heart Rhythm Society ‚  
http://www.hrsonline.org/Patient-Resources/Treatment/Implantable-Cardioverter-Defibrillator#axzz2WDG1QrxV ‚  
National Heart Lung and Blood Institute ‚  
http://www.nhlbi.nih.gov/health/health-topics/topics/icd ‚  
Up To Date ‚  
http://www.uptodate.com/contents/implantable-cardioverter-defibrillators-beyond-the-basics ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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