Cardiac Resynchronization Therapy (CRT)

Implantable Cardioverter Defibrillator (ICD)

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:

Patients are often instructed not to eat or drink anything after midnight prior to the procedure.

Medication Considerations:

Patients taking prescription medications are generally advised to discuss with a physician whether or not to continue to take medications on the day of the procedure. Patients who take blood thinners, such as Coumadin^®, are often advised by their physicians to stop taking this medication for a period of time prior to their ICD insertion. People with diabetes are generally advised to discuss with a physician how best to adjust insulin and food intake prior to the procedure.

Overnight Arrangements:

Patients are advised to pack and bring a small overnight bag.

What to Expect During an ICD Insertion

• An intravenous (IV) tube will be placed into a vein in the arm. A sedative will be dispensed through the IV.
• 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 the patient's 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 the physician.
• It is essential that patients see your physician every three months for follow-up visits following an ICD implantation.