Abnormal Heart Rhythms and Implantable Cardioverter Defibrillators (ICD)
How Should I Prepare for Getting an ICD Implanted?
Before you have your ICD implanted, ask your doctor what medications you are allowed to take. Your doctor may ask you to stop taking certain medications before the procedure. You will receive specific instructions.
If you have diabetes, ask your doctor how you should adjust your diabetes medications.
Do not eat or drink anything after midnight the evening before the procedure. If you must take medications, drink only with a sip of water.
When you come to the hospital, wear comfortable clothes. You will change into a hospital gown for the procedure. Leave all jewelry and valuables at home.
What Happens During the Procedure?
When you have an ICD implanted, you will start by lying on a bed and the nurse will place an intravenous line (IV) into your arm or hand. This is so you may receive medications and fluids during the procedure.
You will be given an antibiotic to prevent infection and a medication through your IV to relax you and make you drowsy, but it may not put you to sleep.
The nurse will connect you to several monitors. The monitors allow the doctor and nurse to check your heart rhythm, blood pressure, oxygen level of your blood, and other measurements during the procedure.
The left or right side of your chest, from your neck to your groin will be shaved and cleansed with a special soap. Sterile drapes are used to cover you from your neck to your feet. A soft strap will be placed across your waist and arms to prevent your hands from coming in to contact with the sterile field.
The ICD may be implanted in two ways, but the endocardial (transvenous) approach is most common.
A small incision is made under the collarbone. The lead is placed into a vein and guided inside your heart chamber. The generator is placed under skin in your upper chest and attached to the lead(s).
On rare occasion, it may be necessary for your doctor to implant your ICD using the epicardial approach (outside your heart). This requires open-heart surgery. Instead of placing the lead through a vein and guiding it to the heart, it is sewn onto the heart. Minimally invasive approaches, such as robotic-assisted surgery, are available to lessen the trauma associated with this type of surgery. Your doctor will decide if this approach is necessary for you.
The ICD implantation procedure takes about two to five hours to perform.
What Happens After the ICD Is Placed?
You will normally be admitted to the hospital overnight after your ICD is implanted.
The morning after your implant, you will have a chest X-ray to make sure the ICD leads are in the proper position and your ICD will be programmed to ensure it is functioning properly.