Implantable Cardioverter Defibrillator (ICD): What You Need to Know

Introduction

An implantable cardioverter defibrillator (ICD) is a small electronic device that is placed inside the body to monitor and correct life-threatening heart rhythms. It is often recommended for patients who have a high risk of sudden cardiac arrest due to ventricular tachycardia or ventricular fibrillation.

How Does an ICD Work?

  1. Monitoring Heart Rhythm: The ICD continuously monitors the heart's electrical activity.
  2. Detecting Dangerous Rhythms: If the heart starts beating too fast or irregularly (arrhythmia), the device detects it.
  3. Providing Therapy:
    • First, it may try to correct the rhythm using pacing (small electrical impulses).
    • If pacing is ineffective, it delivers a shock to restore a normal heartbeat.

Who Needs an ICD?

ICDs are recommended for individuals with: - History of cardiac arrest - Ventricular fibrillation or ventricular tachycardia - Severe heart failure (with reduced ejection fraction under 35%) - Certain genetic heart diseases (e.g., Long QT syndrome, Brugada syndrome)

Life with an ICD

  • Regular Check-ups: ICDs need periodic checks to ensure proper functioning.
  • Physical Activity: Most people can resume normal activities, but contact sports should be avoided.
  • Medical Precautions: Inform healthcare providers about the ICD before undergoing MRI scans or electrosurgical procedures.
  • Device Longevity: The battery lasts 5-10 years and will need replacement.

Potential Risks

  • Infection at the implantation site
  • Lead displacement
  • Inappropriate shocks (rare but possible)

Conclusion

An ICD can be a life-saving device for people at high risk of fatal arrhythmias. While there are some risks, it significantly increases survival chances for those with serious heart conditions.

Source recommendations

1. American Heart Association: Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

  1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
  2. https://pubmed.ncbi.nlm.nih.gov/29097320/
  3. https://academic.oup.com/eurheartj/article/43/40/3997/6675633
  4. https://pubmed.ncbi.nlm.nih.gov/29084733/
  5. https://www.heartrhythmjournal.com/article/S1547-5271(17)31249-3/fulltext

2. European Society of Cardiology Guidelines for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

  1. https://academic.oup.com/eurheartj/article/43/40/3997/6675633
  2. https://pubmed.ncbi.nlm.nih.gov/36017572/
  3. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Ventricular-Arrhythmias-and-the-Prevention-of-Sudden-Cardiac-Death
  4. https://pubmed.ncbi.nlm.nih.gov/26320108/
  5. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549

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