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Defibrillator Implant

What is a defibrillator (ICD device)?
An implantable cardioverter defibrillator (ICD) is a small device that treats abnormal heart rhythms called arrhythmias. Specifically, an ICD treats fast arrhythmias in the heart's lower chambers (ventricles). Two such arrhythmias are ventricular tachycardia (VT) and ventricular fibrillation (VF).

Arrhythmias result from a problem in your heart's electrical system. Electrical signals follow a certain path through the heart. It is the movement of these signals that causes your heart to contract. To learn more about your heart's electrical system, go to the Heart & Blood Vessel Basics section.

During VT or VF, however, far too many signals are present in the ventricles. In addition, the signals often do not travel down the proper pathways. The heart tries to beat in response to the signals, but it cannot pump enough blood out to your body. If you have either VT or VF, you are at high risk of sudden cardiac arrest (SCA). If not treated immediately with defibrillation, SCA can result in sudden cardiac death (SCD).

An ICD can treat VT and VF and restore your heart to a normal rhythm. So it reduces your risk of SCD. The device can deliver several types of treatment:

• Anti-tachycardia pacing (ATP) delivers very small amounts of energy to your heart—so small that you can't feel the treatment.
• Cardioversion is a low-energy shock that treats fast but regular arrhythmias.
• Defibrillation is a high-energy shock that treats fast and chaotic (irregular) rhythms. Defibrillation is painful for an instant, but it can also save your life.

A device implant is a procedure that uses local numbing. General anesthesia is usually not needed.

How is the implant procedure done?
An Implantable cardioverter defibrillator (ICD) system has two parts.
Device—the device is quite small and easily fits in the palm of your hand. It contains small computerized parts that run on a battery.
Leads—the leads are thin, insulated wires that connect the device to your heart. The leads carry electrical signals back and forth between your heart and your device.

Your doctor inserts the leads through a small incision, usually near your collarbone. Your doctor gently steers the leads through your blood vessels and into your heart. Your doctor can see where the leads are going by watching a video screen with real-time, moving x-rays called fluoroscopy.

The doctor connects the leads to the device and tests to make sure both work together to deliver treatment. Your doctor then places the device just under your skin near your collarbone and stitches the incision closed.

What can I expect?
Usually you are told not to eat or drink anything for a number of hours before the procedure. You undress and put on a hospital gown or sheet. Your procedure will be performed in a ”cath lab." You lie on an exam table and an intravenous (IV) line is put into your arm. The IV delivers fluids and medications during the procedure. The medication makes you groggy, but not unconscious.

The doctor makes a small incision near your collarbone to insert the leads. The area will be numbed so you shouldn't feel pain, but you may feel some pressure as the leads are inserted. You may be sedated when the device is tested, since it delivers a shock to your heart.

You may be in the hospital overnight, and there may be tenderness at the incision site. Afterwards most people have a fairly quick recovery.

Important Safety Information
Medications, procedures and tests can have some risks and possible side effects. Results may vary
from patient to patient. This information is not meant to replace advice from your doctor. Be sure to talk
to your doctor about these risks and possible side effects.

An implantable cardioverter defibrillator can protect you from the effects of sudden cardiac arrest by
reviving your heart rhythm. But it is not for everyone, including people with certain steroid allergies.
Procedure risks include infection and tissue damage. In some cases, the device may not respond to
irregular heartbeats or may deliver inappropriate shocks. In rare cases severe complications or device
failures can occur. Electrical or magnetic fields can affect the device. Only your cardiologist knows what
is right for you.

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www.guidant.com

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