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ICD Implantation

ICD Implantation (Implantable Cardioverter Defibrillator)

An ICD (implantable cardioverter defibrillator) is a battery-operated device implanted under the skin. It monitors heart rhythms and delivers electric shocks to restore normal rhythm in case of life-threatening arrhythmias like ventricular tachycardia or fibrillation.

What Is an ICD?

An ICD continuously monitors your heart rhythm. It delivers:

  • Low-energy impulses for minor irregularities
  • High-energy shocks for dangerously fast rhythms

Conditions treated include:

  • Ventricular tachycardia
  • Ventricular fibrillation
  • High-risk congenital heart defects
  • Brugada syndrome
  • QT prolongation syndrome

Types of ICDs

  • Single Chamber ICD
  • Dual-Chamber ICD
  • Biventricular Device (for cardiac resynchronization)

Why Do You Need an ICD?

  • History of sudden cardiac arrest or severe arrhythmias
  • Survivors of heart attack or cardiac arrest
  • Genetic risk factors or congenital heart conditions

Cost Factors

  • Medication and treatment duration
  • Geographic location and hospital infrastructure
  • Surgeon expertise
  • Diagnostic procedures
  • Hospitalization and room charges
  • Medical tourism packages

How Does an ICD Work?

  1. Anti-tachycardia Pacing (ATP): Gentle pulses for fast heartbeat
  2. Cardioversion: Low-energy shocks timed with heartbeat
  3. Defibrillation: High-energy shocks for very fast rhythms
  4. Bradycardia Pacing: Tiny pulses for slow heartbeats

Procedure Overview

Where Is It Performed?

  • Typically in the Electrophysiology Lab or Surgical Suite

Before the Procedure

  • Stop eating after midnight
  • Continue medications with minimal water
  • Avoid bringing valuables
  • Adjust diabetic and blood thinner medications as advised

How Is the Device Implanted?

  • Endocardial Method (Most common):

    • Local anesthesia
    • Leads guided into heart via a vein and attached to pulse generator
    • Device placed under the skin of upper chest

  • Epicardial Method (Rare):

    • General anesthesia
    • Generator placed in lower abdomen

After the Procedure

  • Hospital stay: 24 hours (endocardial), 3–5 days (surgical)
  • Swelling or sensitivity at implant site is common
  • Avoid raising left arm above shoulder for 6–8 weeks
  • Follow all activity restrictions, including no contact sports
  • Regular device check-ups every 6 months

Precautions After ICD Implant

Avoid for the first 4 weeks:

  • Heavy lifting
  • Overhead exercises
  • High-intensity workouts
  • Contact sports

Avoid long-term:

  • Strong magnets (keep 6 inches away)
  • Radar equipment, arc welders, and industrial transmitters

The Most Important Frequently Asked Questions

Q: What Should I Avoid With an ICD?
A: High-voltage equipment, close magnetic fields, certain sports

Q: How Long Is ICD Recovery?
A: 4–6 weeks for full recovery

Q: What Are the Risks?

  • Bleeding or infection
  • Lead displacement
  • Collapsed lung
  • Cardiac perforation

Q: Who Should Not Get an ICD?
A: Patients with <1-year life expectancy or uncontrollable arrhythmias

Q: What Should I Do After ICD Implant?

  • Follow care guidelines
  • Wear loose clothes
  • Avoid chest rubbing
  • Attend all follow-ups
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