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What is an implantable cardioverter defibrillator? An implantable cardioverter defibrillator ICD is a small device that your doctor can put into your chest to help regulate an irregular heart rhythm , or an arrhythmia. The computer delivers small electrical shocks to your heart at certain moments. This helps control your heart rate. Doctors most commonly implant ICDs in people who have life-threatening arrhythmias and who are at risk for sudden cardiac arrest , a condition in which the heart stops beating.

Arrhythmias can be congenital something you were born with or a symptom of heart disease. ICDs are also known as cardiac implantable devices or defibrillators.

Why do I need an implantable cardioverter defibrillator? Your heart has two atria left and right upper chambers and two ventricles left and right lower chambers. Your ventricles pump blood from your heart to the rest of your body. These four chambers of your heart contract in a timed sequence to pump blood throughout your body.

This is called a rhythm. Each node sends out an electrical impulse in a timed sequence. This impulse causes your heart muscles to contract. First the atria contract, and then the ventricles contract. This creates a pump. Heart rhythm problems in your ventricles are very dangerous because your heart can stop pumping. You might benefit from an ICD if you have: a very fast and dangerous heart rhythm called ventricular tachycardia erratic pumping, which is referred to as quivering or ventricular fibrillation a heart weakened by a history of heart disease or a previous heart attack an enlarged or thickened heart muscle, which is called dilated, or hypertrophic, cardiomyopathy congenital heart defects , such as long QT syndrome, which causes heart quivering heart failure How does an implantable cardioverter defibrillator work?

An ICD is a small device implanted in your chest. The main part, which is called a pulse generator, holds a battery and tiny computer that monitors your heart rhythms. If your heart beats too fast or irregularly, the computer delivers an electric pulse to correct the problem. Wires called leads run from the pulse generator into specific areas of your heart.

These leads deliver the electric impulses sent by the pulse generator. Depending on your diagnosis, your doctor may recommend one of the following types of ICDs: A single-chamber ICD sends electrical signals to the right ventricle. A dual-chamber ICD sends electrical signals to the right atrium and right ventricle. A biventricular device sends electrical signals to the right atrium and both ventricles. Doctors use it for people who have heart failure.

An ICD can also deliver up to four types of electrical signals to your heart: Cardioversion. Cardioversion gives a strong electrical signal that can feel like a thump to your chest. It resets heart rhythms to normal when it detects a very fast heart rate.

Defibrillation sends a very strong electrical signal that restarts your heart. The sensation is painful and can knock you off your feet but lasts only a second. Antitachycardia pacing provides a low-energy pulse meant to reset a rapid heartbeat.

Typically, you feel nothing when the pulse occurs. However, you may sense a small flutter in your chest. In this situation, the ICD works like a pacemaker. People with ICDs usually have hearts that beat too fast.

However, defibrillation can sometimes cause the heart to slow down to a dangerous level. Bradycardia pacing returns the rhythm to normal. How do I prepare for the procedure? Your doctor may also ask you to stop taking certain medicines, such as aspirin or those that interfere with blood clotting. Before the procedure, be sure to tell your doctor about the medications, over-the-counter drugs, and supplements you take. You should never stop taking a medication without talking to your doctor first.

What happens during the procedure? An ICD implant procedure is minimally invasive. After making small incisions, the doctor guides the leads through a vein and attaches them to the specific parts of your heart muscle. An X-ray monitoring tool called a fluoroscope may help guide your doctor to your heart.

They then attach the other end of the leads to the pulse generator. The doctor makes a small incision and places the device in a pocket of skin on your chest, most often under your left shoulder. The procedure typically takes between one and three hours.

You should feel fully recovered within four to six weeks. A doctor can also implant an ICD surgically under general anesthesia. In this case, your hospital recovery time can last up to five days.

As with any surgery, an ICD implant procedure may cause bleeding, pain, and infection at the incision site. More serious problems specific to this procedure are rare. However, they can include: damage to your heart, valves, or arteries fluid buildup around the heart.


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