An implantable cardioverter defibrillator (ICD) is a generator with a battery and computer circuits, which is implanted in your chest or abdomen. Electrical wires run from this generator to your heart. The heart is monitored for fast rhythms and the generator will rapidly pace (stimulate) or shock the heart back to a normal rhythm. It stores the information so that your doctor can review it. This is not a cure for an abnormal heart rhythm, simply a treatment.

Before the Procedure
You should not eat or drink anything after midnight before your procedure. You will be required to sign a permit, which explains the procedure and its risks.

If you are a diabetic, talk to your doctor before the procedure because your medication may need to be adjusted. If you have a dye or shellfish allergy, inform your doctor and the electrophysiology lab staff so they can take special precautions to prevent a reaction.

During the Procedure
During the implantation, you will receive a local anesthetic to numb the area of the incision. Anesthetic is a substance that causes a lack of feeling or awareness. If you experience discomfort at any point,  please let the nurse or doctor know and they will give you medication. You will also receive anesthetics to put you to sleep for the testing of the device. You will receive pain medication to take for a few days following the procedure.

After the Procedure
If you have no other medical problems, you may return home the day after the procedure. You will be restricted from moving your arm above your shoulder for two weeks and you will have weight-lifting limitations for a month. It is suggested that you not shower for one week so the wound can properly heal.  

Medical Alert Bracelet or Necklace
It is always good to have some type of identifying information on you about your ICD. Your local pharmacy will be able to help you get a medical alert bracelet or necklace. Make sure you include the manufacturer's name of the device on the bracelet. You will also be given temporary identification when you leave the hospital. You will receive the permanent ID via mail. You should carry the ID with you at all times.

Lifestyle Changes
All states have laws that restrict people from driving if they have ever lost consciousness because of a heart rhythm problem. Your doctor will discuss the restrictions that apply to you specifically.

You will not be allowed to:

• Work on electricity of gas motors
• Be around large magnets
• Do arc and resistance welding
• Use magnet therapy products
• Have a magnetic resonance imaging (MRI) scan that uses magnets and radio waves to create images of your body;
• Have radiation therapy in the area of the ICD

In addition, you cannot use or store cellular phones within six inches of your device. You should not participate in contact sports and never swim alone. Your doctor and nurse will review these restrictions with you.

If you require other surgery at any time, your device will need to be reprogrammed. If you have a surgery scheduled, let your doctor know that you have an ICD, and he or she should be able to answer any questions you may have.

Despite the restrictions associated with ICD devices, people who have them live full and active lives.

Providers

Dawood Darbar, MD, PhD, Director, Vanderbilt Arrhythmia Service
Walter K. Clair, MD
John T. Lee, MD
Katherine T. Murray, MD
Dan M. Roden, MD
Jeffrey N. Rottman, MD
Pablo Saavedra, MD
Mark S. Wathen, MD