What you can expect

During the procedure

Usually, the procedure to implant an ICD can be performed with numbing medication and a sedative that relaxes you but allows you to remain aware of your surroundings. In some cases, general anesthesia, which puts you to sleep, may be used.

The procedure usually takes a few hours. During surgery, one or more flexible, insulated wires (leads) are inserted into veins near your collarbone and guided, with the help of X-ray images, to your heart. The ends of the leads are secured to your heart, while the other ends are attached to the generator, which is usually implanted under the skin beneath your collarbone.

Once the ICD is in place, your doctor will test it and program it for your heart rhythm problem. Testing the ICD might require speeding up your heart and then shocking it back into normal rhythm.

After the procedure

You'll stay in the hospital one or two days, and the ICD might be tested once more before you're discharged. Additional testing of your ICD usually doesn't require surgery.

Treating pain after your procedure

After surgery, you may have some pain in the incision area, which can remain swollen and tender for a few days or weeks. Your doctor might prescribe pain medication. As your pain lessens, you can take nonaspirin pain relievers, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).

Unless your doctor instructs you to do so, don't take pain medication containing aspirin because it can increase bleeding risk.

When you're released from the hospital, you'll need to arrange for a ride home because you won't be able to drive for at least a week.

June 14, 2016
References
  1. Implantable cardioverter defibrillator. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/icd/icd_all.html. Accessed April 4, 2016.
  2. Ganz LI. General principles of the implantable cardioverter-defibrillator. http://www.uptodate.com/home. Accessed April 4, 2016.
  3. Epstein AE, et al. 2012 ACC/AHA/HRS focused update incorporated into the ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities. Circulation. 2013;127:e283.
  4. Devices that may interfere with implantable cardioverter defibrillators (ICDs). American Heart Association. http://www.heart.org/HEARTORG/Conditions/Arrhythmia/PreventionTreatmentofArrhythmia/Devices-that-may-Interfere-with-Implantable-Cardioverter-Defibrillators-ICDs_UCM_448464_Article.jsp. Accessed April 4, 2016.
  5. Living with your implantable cardioverter defibrillator (ICD). http://www.heart.org/HEARTORG/Conditions/Arrhythmia/PreventionTreatmentofArrhythmia/Living-With-Your-Implantable-Cardioverter-Defibrillator-ICD_UCM_448462_Article.jsp. American Heart Association. Accessed April 4, 2016.
  6. AskMayoExpert. Implanted cardiac devices. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
  7. Ganz LI. Implantable cardioverter-defibrillators: Complications. http://www.uptodate.com/home. Accessed April 4, 2016.
  8. Knight BP. Patient information: Implantable cardioverter-defibrillators (beyond the basics). http://www.uptodate.com/home. Accessed April 4, 2016.