Introduction

Implantable Cardioverter Defibrillator (ICD)

Heart rhythm is mainly controlled by the conduction system of the heart. Any abnormality in the conduction system may result in arrhythmia. Life-threatening arrhythmias such as ventricular tachycardia (VT) and ventricular fibrillation (VF) may cause palpitations, dizziness, syncope, or even sudden cardiac death.

Causes

Causes

  • ● Coronary artery disease
  • ● Previous myocardial infarction (heart attack)
  • ● Cardiomyopathy
  • ● Congenital heart disease
  • ● Genetic arrhythmia syndromes (e.g., Long QT syndrome, Brugada syndrome)
  • ● Idiopathic causes (unknown origin)
Symptoms

Symptoms

  • ● Palpitations
  • ● Dizziness
  • ● Chest discomfort
  • ● Syncope (fainting)
  • ● Sudden cardiac arrest
Operation

The Implantable Cardioverter Defibrillator (ICD) Procedure

The ICD implantation procedure is usually performed under local anaesthesia in a catheterization or electrophysiology laboratory. To begin, electrodes are attached to your chest to monitor your heart rhythm throughout the procedure. A small incision, typically 3 to 5 centimetres in length, is made in the upper chest, usually on the left side. Through this incision, one or more leads are inserted into a vein and carefully guided into the heart using X-ray imaging.

Once the leads are properly positioned, they are connected to the ICD pulse generator, which is then implanted under the skin or muscle. After the device is placed, it will be tested to ensure that it functions correctly. The incision is then closed.

The entire procedure usually takes around 3 to 4 hours. Following the operation, your heart rhythm will continue to be monitored, and the device settings will be adjusted as necessary.

Notice

Postoperative Care

  • ● Like any invasive procedure, ICD implantation carries risks such as bleeding, infection, allergic reactions, lead dislodgement, arrhythmias, and device malfunction. Your doctor will discuss these risks and compare them with the benefits of treatment.
  • ● You may be discharged from hospital several days after the implantation.
  • ● The wound should be covered with a light dressing. Please keep the wound site clean and avoid getting the dressing wet during showers. Change the dressing immediately if it becomes wet.
  • ● You may need to return to the clinic or ward for suture removal about 1 week after the procedure. The dressing can usually be removed 2 to 3 days after the stitches are taken out.
  • ● Avoid lifting the affected arm above shoulder level for 1 month and avoid vigorous arm movements during the first week after the procedure.
  • ● You will be scheduled for regular device checks, including analysis, re-programming, and battery assessment. To optimize the benefits, device settings may be adjusted with the assistance of echocardiogram.
  • ● Always carry your device identification card with you.
  • ● Follow your doctor’s instructions or refer to the device company’s information booklet to minimize the risk of device malfunction due to electromagnetic interference. Generally, strong electromagnetic fields or radiofrequency signals can interfere with the device. Keep a distance of more than 15 cm (6 inches) from an active mobile phone. Household electrical appliances usually do not affect the device.
  • ● The device generator will need replacement in 5 to 10 years when the battery is depleted.

For further information, please consult your attending doctor or cardiologist.

The above information is for reference only. As each patient’s condition may vary, please consult your doctor for individual assessment and advice.