Defibrillation Implantation
What is Defibrillator Implantation?
Defibrillator implantation involves surgically placing an Implantable Cardioverter Defibrillator (ICD)—a small, battery-operated device—under the skin to monitor and treat life-threatening arrhythmias. This device is designed to prevent sudden cardiac death in individuals at high risk for abnormal heart rhythms that can lead to cardiac arrest.
About the size of a stopwatch, the ICD is typically implanted beneath the collarbone. It is connected to the heart through thin, flexible wires (leads) that are threaded into the heart chambers. The device continuously monitors the heart's rhythm and, when it detects a dangerous arrhythmia, delivers a controlled electrical shock to restore a normal heartbeat.
In addition to delivering lifesaving shocks, some ICDs also function as pacemakers, providing low-energy impulses to help maintain a steady heart rate if it slows down too much. ICD implantation is a critical preventive tool for patients with a history of, or risk factors for, ventricular tachycardia, ventricular fibrillation, or other serious arrhythmias.
Risks and Benefits of Defibrillation Implantation
ICD devices can save lives by preventing sudden cardiac death. It’s important to note that risks are relatively uncommon with experienced surgeons, and your doctor will take precautions to minimize these risks.
Benefits of Defibrillation Implantation
- Prevents Sudden Cardiac Arrest
Defibrillation implantation is a proven life-saving treatment for dangerous ventricular arrhythmias that can lead to sudden cardiac arrest. - 24/7 Heart Monitoring and Protection
The implanted defibrillator continuously monitors the heart rhythm and is programmed to deliver shocks whenever a life-threatening arrhythmia occurs. - Quick Treatment
The implanted defibrillator can administer an electric shock within seconds to restore normal heart rhythm during a cardiac event. Quick defibrillation is critical for survival.
Risks of Defibrillation Implantation
- Bleeding, Bruising, or Swelling
- Collapsed Lung (Pneumothorax)
- Damage to Blood Vessels or Nerves
- Infection
- Movement of the Device
- Blood Clots
- Hemothorax
What to Expect Before, During, and After Defibrillator Implantation
Implantation of an ICD will take a few hours. The most common procedure is the transvenous approach, which involves a small incision at your collarbone.
We’ll begin with an IV and sedative. We will make an incision near the collarbone or, in some cases, your chest or abdomen. Gaining access through your vein, we put the wires into the heart chambers. The ICD goes in a pouch under the skin. We ensure the leads are connected to both the heart and ICD and that they work properly. Before we end the procedure, we test the device to make sure everything is working as it should.
You will likely go home from the hospital the day after the procedure. You will need to have someone drive you home. You may feel tired and sore at the site of the incision. Your doctor will advise you on the best medication to take for any pain.
We may test the ICD system once again before you leave.
In general, you should refrain from heavy lifting and vigorous activity in the month after the procedure. Avoid putting pressure on the implantation site.
Am I a Candidate for Defibrillation Implantation?
We recommend implantable cardioverter-defibrillator (ICD) devices for patients with certain conditions that put them at risk for cardiac arrest. If you experience dangerously high heartbeats, known as ventricular tachycardia or ventricular fibrillation, you may be a candidate for defibrillator surgery.
You may be considered high-risk if you have the following:
- Abnormal Heart Rhythms
Also known as an arrhythmia, an abnormal heart rhythm is caused by a problem with your heart’s conduction system, causing your heart to beat irregularly. - Previous Heart Attack
Those who have previously had a heart attack may benefit from the implantation of an ICD device. - Heart Failure
Congestive heart failure is a chronic condition in which the heart can’t pump enough blood to meet the body’s needs, causing a buildup of fluid in the lungs and other tissues. - Congenital Heart Defects
Congenital heart defects are problems in the heart's structure that are present at birth. They are the most common type of birth defect. - Cardiomyopathy
When diseases of the heart muscle can’t pump blood effectively, patients are at risk of cardiovascular complications.
Subcutaneous ICD: An Alternative for Certain Patients
While traditional implantable cardioverter defibrillators (ICDs) use leads placed within the heart via veins, a Subcutaneous ICD (S-ICD) offers an effective, lead-free option for certain patients at risk of sudden cardiac arrest. Instead of being placed in the heart, the S-ICD sits just beneath the skin, reducing the risk of complications associated with venous access and long-term lead-related issues.
Key Benefits of S-ICD
- Lead-Free Design: No wires are placed in the heart, reducing the risk of infection and lead-related complications.
- Minimally Invasive Placement: The device is implanted under the skin near the ribcage, making the procedure less complex than traditional ICD implantation.
- Preserves Venous System: Ideal for patients with difficult vascular access or those who may require future therapies requiring venous preservation.
- Effective Protection: Provides life-saving shocks to correct dangerous arrhythmias just like a traditional ICD.
Who is a Candidate for S-ICD?
S-ICD may be a good option for patients who:
- Are at risk of sudden cardiac arrest but do not need pacing therapy
- Have limited venous access or conditions that make traditional ICD placement challenging
- Prefer a lead-free alternative to minimize long-term complications
Our specialists will evaluate your condition to determine whether an S-ICD or traditional ICD best fits your needs.