ICD surgery is the procedure to implant an implantable cardioverter-defibrillator (ICD) in the chest. An ICD is a small, battery-powered device that constantly monitors your heart rhythm and delivers electric shocks, when needed, to correct life-threatening irregular heartbeats (arrhythmias) and restore a normal heart rhythm.
Understanding the ICD and its Function
- Monitoring Heart Rhythm: The ICD continuously monitors the heart's electrical activity.
- Detecting Arrhythmias: It identifies dangerous arrhythmias like ventricular tachycardia and ventricular fibrillation.
- Delivering Therapy: When a life-threatening arrhythmia is detected, the ICD can deliver one or more of the following therapies:
- Pacing: Delivers small electrical impulses to correct a slightly fast or irregular heartbeat.
- Cardioversion: Delivers a low-energy electrical shock to reset the heart rhythm.
- Defibrillation: Delivers a high-energy electrical shock to restore a normal heart rhythm.
- Battery Powered: The device is powered by a battery that typically lasts several years, depending on usage.
The ICD Implantation Procedure
ICD implantation is generally performed by a cardiologist or electrophysiologist. The procedure typically involves:
-
Preparation: The patient is given a local anesthetic to numb the area of the chest where the ICD will be implanted (usually near the collarbone). Sedation may also be provided to help the patient relax.
-
Incision: A small incision is made in the chest.
-
Lead Placement: One or more leads (thin, insulated wires) are inserted into a vein and guided to the heart. X-ray imaging (fluoroscopy) is used to help position the leads in the correct location within the heart chambers.
-
Generator Placement: A pocket is created under the skin in the chest to hold the ICD generator (the main part of the device).
-
Connecting Leads: The leads are connected to the generator.
-
Testing: The ICD is tested to ensure it can accurately detect and treat arrhythmias.
-
Closure: The incision is closed with sutures.
Why is ICD Surgery Performed?
ICD surgery is performed to prevent sudden cardiac death in individuals at high risk for life-threatening arrhythmias. Common reasons for ICD implantation include:
- Previous Cardiac Arrest: Having survived a sudden cardiac arrest.
- Ventricular Tachycardia or Fibrillation: Experiencing sustained ventricular tachycardia or ventricular fibrillation.
- Heart Failure: Having significant heart failure.
- Inherited Heart Conditions: Having certain inherited heart conditions that increase the risk of arrhythmias, such as long QT syndrome or hypertrophic cardiomyopathy.
- Coronary Artery Disease: Having severe coronary artery disease with a history of heart attack.
Post-Surgery Care
After ICD surgery, patients typically stay in the hospital for a day or two. Post-operative care includes:
- Wound Care: Keeping the incision clean and dry.
- Activity Restrictions: Avoiding strenuous activities for a few weeks.
- Follow-up Appointments: Attending regular follow-up appointments with the cardiologist to monitor the ICD's function and battery life.
- Medications: Taking any prescribed medications as directed.
- ICD Identification Card: Carrying an ICD identification card to inform medical personnel about the device.
In summary, ICD surgery involves implanting a device that can prevent sudden cardiac death by monitoring the heart rhythm and delivering electrical therapy when dangerous arrhythmias occur.
