Defibrillator Implantation

Procedure

What Is Involved In ICD Implantation?

ICD insertion is a common procedure. This is performed under local anaesthetic with sedative medication to make you feel comfortable. The procedure takes approximately 1-2 hours and is performed in the cardiac catheter laboratory. This is a special room that has a patient table, X-Ray tube, ECG monitors and other equipment. The staff in the lab will all be dressed in hospital theatre clothes and during the procedure will be wearing hats and masks. Many ECG monitoring electrodes will be attached to your chest area. A nurse or doctor will insert an intravenous line usually into the back of your hand. This is needed as a reliable way to give you medications during the study without further injections.

You will also have a blood-pressure cuff attached to your arm that will automatically inflate at various times throughout the procedure. There will also be considerable attention at cleaning the skin under the collarbone where the ICD will be inserted. You will also receive antibiotics prior to the procedure. You should ensure that you inform the Doctor if you have any allergies.

The ICD is inserted just under the collarbone. The area is prepared with a special sterile solution that may feel cold. A large sterile sheet that will partly cover your face will cover you. You will be able to look out from under the sheet to the side and a nurse will be present at all times. You will be given oxygen to breathe by a small tube that is positioned under your nostrils.

At the start of the procedure, the doctor will inject local anaesthetic into the area under the collarbone where the ICD is to be inserted. This will sting momentarily but the area will then be numb. During the procedure you may feel some firm pushing in the shoulder area but this should not be painful. If you experience pain or discomfort you should tell the nurse or doctor. At the end of the procedure a fast heart rhythm will be induced and the effectiveness of the ICD will be tested. For this testing you will receive stronger sedation or occasionally a general anaesthetic. It is unlikely that you will remember much of the procedure.

After the procedure you will have some bruising and discomfort in the area of the pacemaker that may persist for several weeks. You should avoid strenuous activities with your arm for a period of 4 weeks. If the ICD is implanted without previous rhythm disturbance (primary prevention) you are legally required to refrain from driving for 2 weeks after the procedure. If the ICD is implanted after previous rhythm disturbance (secondary prevention) you are legally required to refrain from driving for 6 months and then after clearance by your Doctor.

You will be allowed to go home 1 or 2 days after the procedure.


  • Professor Sanders says...

     
    Atrial fibrillation is a consequence of several reversible risk factors - high blood pressure, diabetes, obesity, sleep apnoea, and excessive alcohol. Your management of atrial fibrillation must include strict control of these risk factors.