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By Mayo Clinic staffTo determine whether you need an ICD, your doctor may perform any of these diagnostic tests:
- Electrocardiography (ECG). In this noninvasive test, sensor pads with wires attached, called electrodes, are placed on your chest and, sometimes, limbs to measure your heart's electrical impulses. Your heart's beating pattern can offer clues to the type of irregular heartbeat you have.
- Echocardiography. This noninvasive test uses harmless sound waves that allow your doctor to see your heart without making an incision. During the procedure, a small, plastic instrument called a transducer is placed on your chest. It collects reflected sound waves (echoes) from your heart and transmits them to a machine that uses the sound wave patterns to compose images of your beating heart on a monitor. These images show how well your heart is functioning, and recorded images allow your doctor to measure the size and thickness of your heart muscle.
- Electrophysiology study (EPS). In this procedure, electrodes are guided through blood vessels to your heart and used to test the function of your heart's electrical system. This can identify your whether you currently have or may develop heart rhythm problems.
- Holter monitoring. Also known as an ambulatory electrocardiogram monitor, a Holter monitor records your heart rhythms for an entire 24-hour period. Wires from electrodes on your chest go to a battery-operated recording device carried in your pocket or worn on a belt or shoulder strap. While you're wearing the monitor, you'll keep a diary of your activities and symptoms. Your doctor will compare the diary with the electrical recordings to try to figure out the cause of your symptoms.
- Event recorder. Your doctor may ask that you wear a pager-sized device that records your heart activity for a day or so. Unlike a Holter monitor, it doesn't operate continuously and you turn it on only when you feel your heart is beating abnormally.
Your doctor will give you specific instructions on what to do immediately before your surgery to prepare. It's likely you'll be asked not to eat or drink anything for at least eight hours before your surgery. Talk to your doctor about any medications you take, and whether or not you should continue to take them before your procedure to implant an ICD.
References
- Epstein AE, et al. ACC/AHA/HRS 2008 Guidelines for device-based therapy of cardiac rhythm abnormalities. Circulation. 2008;117(21):e350-408.
- Implantable cardioverter defibrillator. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=11227. Accessed Oct. 14, 2008.
- Arnsdorf MF, et al. General principles of the implantable cardioverter-defibrillator. http://www.uptodate.com/home/index.html. Accessed Oct. 14, 2008.
- Arnsdorf MF, et al. Role of implantable cardioverter-defibrillator for the secondary prevention of sudden cardiac death. http://www.uptodate.com/home/index.html. Accessed Oct. 14, 2008.
- Healy J, et al. Life and death after ICD implantation. New England Journal of Medicine. 2008;359(10):1058-1059.
- Kleemann T, et al. Annual rate of transvenous defibrillation lead defects in implantable cardioverter-defibrillators over a period of >10 years. Circulation 2007;115(19):2474-2480.
- Epstein AE, et al. Addendum to "Personal and public safety issues related to arrhythmias that may affect consciousness: Implications for regulation and physician recommendations: A medical/scientific statement from the American Heart Association and North American Society of Pacing and Electrophysiology." Circulation. 2007;115(9):1170-1176.
- Sljapic TN, et al. Driving restrictions in patients with an implantable cardioverter-defibrillator. http://www.uptodate.com/home/index.html. Accessed Oct. 14, 2008.
- Arnsdorf MF, et al. Implantable cardioverter-defibrillators: Patient follow-up. http://www.uptodate.com/home/index.html. Accessed Oct. 14, 2008.
