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Beginner's Guide to Implantable Cardioverter Defibrillator (ICD)

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Beginner's Guide to Implantable Cardioverter Defibrillator (ICD)

Cardiac Surgery | by Dr. Ratan Kumar Das | Published on 02/02/2023


Overview About ICD :

The advancements in medical science and technology have paved way for modern medical equipment which can prevent life-threatening conditions due to severe heart disorders. Implantable Cardioverter Defibrillator (ICD) is one such device that can prevent fatalities due to sudden cardiac arrest and improve the overall quality of life.

If you are planning to under the procedure, you can refer to this blog to know about the ICD and how you can manage your life after the procedure. However, this blog is for informational purposes and does not replace the significance of a cardiologist consultation. Read along to know more.

What is Implantable Cardioverter-Defibrillator (ICD) Procedure Done?

An implantable cardioverter-defibrillator (ICD) is a medical device placed in the chest to detect and prevent irregular heartbeats, also known as arrhythmias. An ICD is a battery-powered device that delivers an electric shock to restore a normal heartbeat in case of abnormal heart rhythms.

The doctors may recommend an ICD in case your heart is unable to supply enough blood to the rest of the body. This is usually due to weak heart muscles which result in medical conditions such as ventricular tachycardia, ventricular fibrillation, arrhythmia, etc.

An ICD is a type of cardiac therapy device that has two basic types - Traditional ICD and Subcutaneous ICD (S-ICD). While the former is implanted in the chest with wires attached to the heart, the latter is implanted under the skin at the side of the chest. A traditional ICD is implanted through invasive surgery. On the other hand, a subcutaneous ICD is attached to an electrode and is generally larger than a traditional ICD.

Why Is an Implantable Cardioverter-Defibrillator (ICD) Done?

Primarily, cardiologists recommend ICDs to monitor and regulate irregular heartbeats. Implantable cardioverter-defibrillators are effective in preventing frequent episodes of cardiac arrest and reducing fatality rates. Furthermore, in case of severe medical conditions, patients mostly benefit from ICD if -

  • They have a history of coronary heart diseases or coronary artery diseases which have weakened the heart muscles.
  • They have enlarged heart muscles
  • They have acute myocardial infarction
  • They have a congenital heart disease which increases the risk of rapid heart rhythms
  • They are at an increased risk of frequent cardiac arrest
  • They are diagnosed with rare conditions which may affect the heartbeat

Precautions After Implantable Cardioverter-Defibrillator (ICD) Procedure:

Implantable Cardioverter-Defibrillator (ICD) is a battery-operated pulse generator that is implanted either under the skin or along the ribs. After the procedure, when the patients return to their daily routine, the doctor suggests several preventive measures to ensure the smooth working of an ICD.

The aim is to prevent electrical interferences with the ICDs to increase the life expectance of the patient. Discuss your condition with the doctor during your follow-up sessions to ensure the optimum efficiency of ICD. Here are some preventive measures that you must keep in mind after your ICD procedure -

  • Cellular phones and other mobile devices - While it is safe to talk on the cellphone, patients with an ICD must avoid placing the cell phone close to the (about 6 inches) ICD site. Therefore it is not recommended to keep the cell phone in the upper shirt pocket as the device can mistake a cellphone's signal for a heartbeat and regular the rhythm of the heart accordingly.
  • Security systems - Carry an ID card after the procedure which states you have an ICD. It can be convenient during airport security checks to avoid metal detectors that can interfere with the ICD. You can also ask the security personnel to limit scanning with the hand-help detector to not more than 30 seconds.
  • Medical equipment - In case you have to undergo a diagnostic test or a surgical procedure, you can inform your doctor that you have an ICD. Some diagnostic tests such as magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), and radiofrequency or microwave ablation are not recommended for patients with an ICD.
  • Power generators - Avoid close proximity to welding equipment, radar machinery, smelting furnaces, high-voltage transformers, or motor-generator systems, and keep a distance of at least 2 feet (0.6 meters) to prevent interference with the Implantable Cardioverter Defibrillator (ICD).
  • Household Equipment - Common household electronic equipment such as radio or television, headphones, heating pads, etc. may contain a magnetic substance that can interfere with an ICD. Keep headphones and wireless chargers at least 6 inches (about 15 centimeters) from an ICD.
  • Magnets - Magnets most commonly interfere with the working of an ICD, and long exposures can also lead to severe medical conditions. Therefore, it is important to maintain healthy proximity (at least 6 inches) from magnetic equipment or sites that use large magnets if you have an implantable cardioverter defibrillator (ICD).
  • Driving Restrictions - If your implantable cardioverter defibrillator (ICD) is implanted to treat ventricular arrhythmia, you should avoid driving. The combination of abnormal heartbeat and electrical impulses from an ICD can sometimes cause fainting, which can be dangerous for people who drive. The doctor may recommend waiting for several months before driving a vehicle.

Conclusion:

An implantable cardioverter defibrillator (ICD) is the primary treatment for people experiencing frequent episodes of cardiac arrest. Once implanted, the ICD constantly monitors your heart rhythms to make sure they are steady. When the device detects an abnormal heartbeat, it delivers a shock to the heart to regulate the rhythm heart. It can be effective in preventing heart disorders which can cause life-threatening conditions.

 

FAQs

 

What are the diagnostic tests recommended before the implantable cardioverter defibrillator (ICD) procedure?

Here are some diagnostic tests that the doctor may recommend before your ICD procedure -

  • Electrocardiography (ECG or EKG)
  • Event recorder
  • Echocardiography
  • Holter monitoring
  • Electrophysiology study (EP study) 

Are there any complications of an implantable cardioverter defibrillator (ICD)?

While an implantable cardioverter defibrillator (ICD) is a safe procedure to regulate heart rhythm, there may be rare risks associated with the procedure depending on the medical condition of the patient, the severity of the heart disease, etc. Here are some possible risks of having an ICD -

  • Infection at the implant site
  • Abnormal swelling, bleeding, or bruising
  • Damage to the blood vessel from ICD leads
  • Bleeding around the heart, which can be life-threatening
  • Blood leakage through the heart valve (regurgitation)
  • Collapsed lung (pneumothorax)
  • Shifting the device or leads from their original position can cause cardiac perforation