A tiny battery-operated device known as an implanted cardioverter-defibrillator (ICD) is inserted into the chest to identify and treat abnormal heartbeats called arrhythmias. When required, an ICD will be administered to give electric shocks to the heart to help it return to a normal rhythm.

If a patient has a heart rhythm disorder (arrhythmia) with a dangerously rapid heartbeat that prevents their heart from pumping enough blood to the rest of the body, such as through ventricular tachycardia or ventricular fibrillation, or if they are at high risk for developing one, typically due to a weak heart muscle, they may require an ICD. A pacemaker, an implanted device that may stop dangerously slow heartbeats, is different from an ICD.

Types of ICDs: One kind of cardiac treatment device is an ICD. There are two fundamental kinds:

• The leads (wires) of a conventional ICD are attached to the heart after being implanted in the chest. Implant surgery necessitates extensive surgery.
• Another alternative is a subcutaneous ICD (S-ICD), which is inserted beneath the skin at the side of the chest, just below the armpit. It is connected to a breastbone-length electrode. Although an S-ICD is not attached to the heart, it is bigger than a conventional ICD.

Reasons for inserting an ICD:

An ICD continuously checks for abnormal heartbeats and attempts to rectify them right away. When the heart ceases to beat efficiently, a condition called cardiac arrest, this procedure will help. If a patient has had any of the warning signs or symptoms of prolonged ventricular tachycardia, which include fainting, the doctor may advise that they have an ICD. If they were able to recover from a cardiac arrest, an ICD could also be advised. 

Additional benefits of having an ICD include:

● A history of heart attack and coronary artery disease that has damaged the heart and increased heart size

● A hereditary cardiac disorder that raises the possibility of dangerously rapid heart rhythms, including some forms of long QT syndrome.

● Other uncommon disorders that might impact heartbeat. If there are structural issues with the heart that make it impossible to link wires to the heart through the blood vessels, a medical professional could advise installing an S-ICD.

Details of the procedure:

A. Before the procedure: 

The doctor could advise patients to do the following before getting an ICD:

• Several hours prior, the patient should not eat or drink anything except water.
• To make sure patients are fit for the surgery, they need to have an electrocardiogram, blood tests, and urine testing.
• If they use any blood thinners or have any bleeding issues, let the doctor know.
• Any medicine, bee sting, shellfish, iodine, contrast dye, or other allergies should be disclosed.
• If the patient has asthma, diabetes, renal illness, or any other medical issues, let the medical staff know.

B. During the procedure:

A hospital or clinic is a place where an ICD procedure is carried out. It takes some time. The health, the type of device, and any concurrent surgical operations will all influence the sort of procedure patients are to receive. The most frequent technique is the transvenous method. A little incision close to the collarbone is necessary. The leads are inserted into veins by the healthcare practitioner so they may reach the heart. Open-heart surgery, however, is occasionally necessary for implantation.

ICD procedures might differ greatly. But typically, your healthcare professional will:

1. Use an IV to provide an anesthetic and make you sleepy or relaxed.

2. Use a local anesthetic to numb a skin region.

3. Cut yourself close to the collarbone, chest, or abdomen (belly).

4. Wires are inserted into the chambers of the heart via the subclavian vein.

5. Put the ICD in a skin-level bag.

6. Attach the leads to the ICD and the heart.

7. To make sure everything is connected properly and functioning properly, test the gadget and cables.

8. Glue the wound shut.

9. Before sending the patient to recovery, have the system tested once more.

C. After the procedure:

Patients could experience fatigue and pain after ICD installation, particularly close to the incision. To help them feel more comfortable, the doctor may advise taking painkillers. A lot of patients return home the day following surgery. They might need to stay in the hospital for a few days, depending on their health and the nature of the treatment they underwent. The healthcare professional could test the ICD system once more just before the patients go home.