Implantable Cardioverter Defibrillator (ICD)

Pre-Test Procedures

1. After checking in, you will go to the Pre and Post Procedure area and stay there until you are ready to go in for your ICD implant.
2. You will be required to change into a hospital gown and have your chest clipped and scrubbed with a cold cleaning solution.  This is also an opportunity to use the toilet if needed.
3. An intravenous (IV) will be placed in the arm and will provide medications to prevent infections and keep you comfortable throughout the procedure.
4. The implant will occur in a special room called the Procedure Lab.  A doctor will meet you in the Pre and Post Procedure Area and escort you to the Procedure Area.  You may ask any last questions and sign the consent for the ICD.
5. Only one friend or relative can wait with you in the Pre and Post Procedure Area. 

Test Procedures – 1 – 3 hours

1. A doctor, a team of nurses and an X-ray technologist will put in your device, all wearing gowns, masks, hats and lead aprons.
2. Your chest will be washed again with the cold cleaning solution and sterile sheets will be placed over you.
3. The ICD has two basic parts: the generator (sometimes called the battery) and one or more wires, called leads.  The generator contains the battery, electronic circuitry and a computer that make the ICD work properly.  The generator can be programmed to detect harmful heart rhythms.  The leads are special wires that connect on one end to the generator and the other end to a spot inside your heart.  
4. In general, ICD generators are implanted on the left side of the chest, just below the collarbone.  
5. When the generator senses abnormal heart rhythms, it sends out either pacing pulses, or an electric shock to the heart through the leads.  Your device does not prevent the abnormal rhythm from happening, but it tries to correct the abnormal rhythm as it occurs.  
6. Freezing will be given to numb the areas below your collarbone, where the generator will be put in.  This may sting or burn for a short time.
7. Once the freezing has taken effect, the doctor will make a small cut.  The ICD leads will be threaded through veins to the heart, guided by X-ray.  This is not painful, but you may feel some pressure as the veins are entered.  The generator is placed just under the skin.  Tell the nurse if you have any pain or concerns, and remain as still as possible.

Post-Test Procedures

1. After the implant, you will be taken back to the Pre and Post Procedure area on a stretcher.
2. A heart monitor will be attached to you, measuring your heart rate and blood pressure.  Additionally, a chest X-ray of your ICD placement will be completed, as well as an electrocardiogram (ECG).
3. A nurse from the Pacemaker/Defibrillator Clinic will come and see how your chest is working by placing a wand on your chest.  It does not hurt when your device is checked.  
4. Notify the nurse of any pain at the ICD implantation site.  Your position may be altered or pain medication may be given to you.
5. You can eat and drink normally in the Pre and Post Procedure area, with your nurse providing you a drink and snack.
6. Refrain from lifting your arm on the side of the ICD implant above your head or lifting greater than 5 pounds for the first 4 weeks.
7. You may experience bruising or color changes in your skin around the implant site.  If you were on a blood thinner before the procedure, this may be more noticeable.