Automatic Cardioverter Defibrillator Implantation
Automatic Cardioverter Defibrillator Implantation
(Implantable Cardioverter Defibrillators [ICD]; Automatic Implantable Cardioverter Defibrillator [AICD])
|Implanted Cardioverter Defibrillator|
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Reasons for Procedure
- Bradycardia —heart beating too slowly
- Ventricular tachycardia —heart beating too rapidly
- Ventricular fibrillation —heart muscle not pumping, but just quivering
- Have had one or more episodes of serious arrhythmias (irregular heart rhythms)
- Have had a heart attack and at high risk for arrhythmias
- Have a high risk of dangerous arrhythmias
- Have a weakened heart muscle (high risk for dangerous arrhythmias)
- Have a high likelihood of developing an arrhythmia
- Have the condition known as hypertrophic cardiomyopathy (an enlarged heart muscle that does not function properly)
- Damage to the heart or lungs
- Damage to blood vessels
- Inappropriate shocks or device malfunction
What to Expect
Prior to Procedure
- Blood tests
- Chest x-ray —a test that uses radiation to take a picture of structures inside the body
- Electrocardiogram (ECG), implantable loop recorders (ILR), electrophysiology study (EPS)—tests that record the heart’s activity by measuring electrical currents through the heart muscle
- Echocardiogram —ultrasound test to evaluate heart structure and function
- Stress testing or cardiac catheterization —to evaluate for coronary artery disease
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Aspirin or other anti-inflammatory drugs
- Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
- The night before, eat a light meal. Do not eat or drink anything after midnight.
- Ask your doctor if you should take your daily medicines the day of the procedure with a sip of water.
Description of the Procedure
Immediately After Procedure
How Long Will It Take?
How Much Will It Hurt?
Average Hospital Stay
- Keep the bandage over the incision are clean and dry. Follow your doctor's instructions to clean the area.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- Do not drive for up to six months. Talk with your doctor to determine how long you should wait to drive.
- Avoid lifting objects over 10 pounds until six weeks after surgery.
- Avoid vigorous activity for 4-6 weeks following surgery. This especially applies to upper body activities. Be very careful of your arm and shoulder on the side where the device was implanted. You want to avoid dislodging the device's leads.
- Avoid any activity that involves rough contact to your chest or abdomen, such as contact sports.
- Return to work and regular daily activities as soon as you are ready. Sexual relations may resume as soon as you are able.
- Make and keep all postoperative appointments.
You may need to avoid:
- Magnetic resonance imaging ( MRI scan)
- Heat therapy (often used in physical therapy)
- High-voltage or radar machinery, such as electric arc welders, high-tension wires, radar installations, or smelting furnaces
- Contact with radio or television transmitters
- Do not carry a cell phone in a pocket directly over the device. Keep your phone on the side away from the device. Also, headphones worn with MP3 players (eg, iPods) may cause interference.
- Turn off car or boat motors when working on them. They may temporarily confuse your device.
- Tell your doctor or dentist that you have a device before a surgical procedure.
- Check with your doctor about the safety of going through airport security detectors with your particular device. Do not linger in security devices.
- Be sure to follow your doctor’s instructions .
Call Your Doctor
- You feel a shock
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
- Pain that you cannot control with the medicines you have been given
- Cough or severe nausea or vomiting
- You have chest pain or shortness of breath
- You feel lightheaded or dizzy and do not feel a shock
- You are still feeling symptoms after a shock
- You feel three or more shocks in a row
American Heart Association http://www.americanheart.org/
Heart Rhythm Society http://www.hrspatients.org/
Health Canada http://www.hc-sc.gc.ca/
Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca/splash/
American College of Cardiology Foundation and the American Heart Association. ACC/AHA guideline update for implantation of cardiac pacemakers and antiarrhythmic devices. American Heart Association website. Available at: http://www.americanheart.org/downloadable/heart/1032981283481CleanPacemakerFinalFT.pdf . Accessed November 30, 2009.
Common questions about ICDs. Heart Rhythm Society website. Available at: http://www.hrspatients.org/patients/treatments/cardiac%5Fdefibrillators/common%5Fquestions.asp . Accessed January 12, 2009.
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Implantable cardioverter defibrillator (ICD). Cleveland Clinic Heart Center website. Available at: http://www.clevelandclinic.org/heartcenter/pub/guide/tests/procedures/icd.htm . Accessed January 12, 2009.
Implantable cardioverter defibrillator (ICD). Heart Rhythm Society website. Available at: http://www.hrspatients.org/patients/treatments/cardiac%5Fdefibrillators/default.asp . Accessed January 12, 2009.
Implantable cardioverter defibrillator (ICD). Stanford University School of Medicine Medical Center website. Available at: http://www.stanfordhospital.com/clinicsmedServices/COE/heart/relatedServices/implantableCardioverterDefibrillator.html . Accessed January 12, 2009.
Implantable cardioverter defibrillator (ICD). US Food and Drug Administration website. Available at: http://www.fda.gov/hearthealth/treatments/medicaldevices/icd.html . Accessed January 12, 2009.
Implantable cardioverter defibrillator (ICD): controlling a chaotic heart. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/implantable-cardioverter-defibrillator/MY00336 . Accessed January 12, 2009.
More about implantable cardioverter defibrillators (ICDs). University of San Francisco Department of Cardiology website. Available at: http://cardiology.ucsf.edu/ep/debris/icd2.htm . Accessed January 12, 2009.
Pacemakers and defibrillators: Frequently asked questions. University of Iowa Virtual Hospital website. Available at: http://www.uihealthcare.com/topics/medicaldepartments/internalmedicine/pacemakersanddefib/index.html . Accessed: January 12, 2009.
Reiffel JA, Dizon, J. The implantable cardioverter-defibrillator: patient perspective. Circulation. 2002;105:1022-1024.
Winters SL, et al. Consensus statement on indications, guidelines for use, and recommendations for follow-up of implantable cardioverter defibrillators. Journal of Pacing and Clinical Electrophysiology. 2001;24:262-269.
Zipes: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 7th ed. Philadelphia, PA: Saunders; 2005.
11/19/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Lee S, Ransford B, Fu K, Tadyoshi K, Maisel W. Abstract 662: electromagnetic interference (EMI) of implanted cardiac devices by MP3 player headphones. Circulation . 2008;118:S596.
- Reviewer: Michael J. Fucci, DO
- Review Date: 11/2012 -
- Update Date: 11/26/2012 -