Defibrillators, otherwise known as ICDs, or Implantable Cardioverter-Defibrillators, are prescribed for patients who have had or who are at risk of having life-threatening tachycardias (fast and dangerous heart rhythms). The unit monitors the heart rate at all times and is able to pace or shock a patient back into a regular rhythm, if needed. A cardiologist places this in much the same way as a pacemaker, above, except one of the leads is an ICD lead, and the generator (ICD unit) is slightly larger. An anesthesiologist is also present, who will give sedation throughout the procedure and short-term anesthesia, during which the doctor will test the ICD toward the end of the surgery. Once the device is tested, the wound is closed with dissolvable sutures, and a dressing is placed. The ICD patient will stay the night in the hospital for monitoring, with his or her arm in a sling, as above, and is usually released the next morning. An ICD patient needs to avoid lifting his affected arm above his head for 2-4 weeks after the surgery, in order to prevent movement of the leads. A patient is asked to leave the dressing in place, clean and dry, for 3 days following the procedure to prevent infection.
A representative will be present from one of several companies and will provide educational information about the patient’s particular unit, along with an ID card.
Preparation for this test involves not eating or drinking for 8 hours before the procedure start time, except for some medications with a sip. Blood thinners may need to be stopped, but each patient will be given specific instructions by phone about these. We have ICD patients check into TMCA 2 hours ahead of the procedure start time in the Surgery Waiting Room.