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What is an ICD?
ICD stands for Implantable Cardioverter Defibrillator. If your doctor has suggested you need an ICD you may have experienced, or be at risk of experiencing, an abnormal, fast heart rhythm. An ICD can recognise and monitor your heart rhythm and can deliver various electrical treatments if needed.
It is a small,slim box shaped device containing a battery and electronic circuits. It is usually placed under the skin below the collarbone, normally on the left hand side.
1) If your heart rhythm is too slow the device can give your heart extra support by working as a normal pacemaker (anti bradycardia pacing).
2) If your heart beats too fast , the ICD can give you a burst of extra beats at a slightly faster rate which should return your heart to a normal rhythm.(Anti tachycardia pacing)
3) If the anti-tachycardia pacing doesn’t bring your heart back to a normal rhythm or the ICD senses a faster, dangerous rhythm called ventricular fibrillation, the ICD can then give a shock.(Defibrillation)
The procedure is carried out under general anaesthetic or a local anaesthetic and sedation. The ICD generator is connected to either 1 or 2 leads which pass through a vein into the heart. The doctor may test the device during the procedure to ensure it is working correctly. The implant should take between 1 and 2 hours. Any stitches that subsequently need to be removed will be done at your GP surgery.
You will probably be allowed to go home the next day provided your ICD is checked and there are no complications.You will be given an ICD emergency card, emergency information and instructions at this point. You will also be given a helpline number if you should have any queries later on.
Normally an ICD battery lasts 6 to 9 years and the replacement procedure usually involves changing the ICD generator, not having new leads implanted
You will be conscious of the device under your skin, at least at first, and may feel it weigh against the skin when you bend. Some patients are more conscious of the device in cold weather. Some also report feeling the device vibrate slightly in response to loud noise.
Talk to your doctor or cardiac nurse. If there is no reason vigorous exertion is likely to be harmful and the device is fully healed(usually 4- 6weeks after fitting),then sexual relations may resume if you feel up to it.
Some patients have reported that having shocks can feel like they have been punched or kicked in the chest. These shocks can be quite painful but the pain will only last a few seconds. Other patients may not feel anything.
If you feel unwell after a shock or if your device has given you several shocks, please dial 999 for an ambulance. Show the paramedic your identity card along with any emergency instructions. This will inform them of exactly which type of device you have and what the best course of action will be.
If you are suffering from a terminal illness there may come a time when your device needs to have its defibrillator function deactivated. The most appropriate time to do this will vary according to your individual circumstances. You will need to have a frank discussion with your family and medical care team to decide on the course of action most appropriate to you.