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What to Expect if You Need an Implantable Cardioverter Defibrillator

If you have certain heart problems or conditions, your doctor might recommend an implantable cardioverter defibrillator (ICD). The idea of having something placed inside your body that can shock your heart might, understandably, make you feel nervous or anxious. But ICDs can help keep your heart functioning normally and can even save your life. 

“Many people are afraid that after getting an ICD, they won’t be able to live a normal, active life. But most people can continue to do the activities they love,” said Heather Schminke, a quality specialist at the CardioVascular Institute of North Colorado Cardiology Clinic

According to the American Heart Association (AHA), your doctor might suggest an ICD if you have or have had: 

  • Ventricular arrhythmia, where the lower chambers of your heart don’t pump properly 
  • Heart attack
  • Sudden cardiac arrest
  • Long QT syndrome, an irregularity in your heart’s electrical system
  • Brugada syndrome, where your heart beats dangerously fast
  • Congenital heart disease

What do ICDs do?

ICDs keep track of your heart rate 24 hours a day. If they detect an abnormally fast heart rate, they deliver an electric shock to bring your heartbeat back to normal. If they notice a slow heart rate, they can send signals to your heart, like a pacemaker, to speed up your heart rate.

How is an ICD implanted?

The ICD is usually implanted just below your collarbone, with wires that link it to your heart. The wires run through your blood vessels, so you don’t need open-heart surgery. “The procedure typically is done with conscious or light sedation and usually takes an hour or two,” Schminke said. You’ll probably go home the same day.

You’ll feel sore around the surgical site for a few days. You won’t be able to lift above your shoulder or lift heavy objects with the arm on the side of the implant for a few weeks.

“Life should pretty much return to normal with no real limitations from the device after a few weeks,” said Shane Rowan, MD, an electrophysiologist at Banner Health in Colorado.

How does an ICD get power?

Your ICD will contain a battery that should last five years or more. Your doctor can check the battery as part of your regular evaluations. 

If the ICD shocks me, will it hurt?

Keep in mind that if the ICD shocks you, it’s doing its job. That said, “If you are awake when the device shocks you, you will almost certainly notice it. Most people describe the sensation as like being kicked in the chest. It is uncomfortable and startling,” Dr. Rowan said. However, you might pass out from an irregular heart rhythm before the device can shock you. In that case, you won’t be aware of the shock.

What should I do if I get a shock?

You’ll probably feel fine afterward, but you should call your doctor soon. Your doctor may want to schedule a follow-up visit. If you don’t feel well or have chest pain, call 911. Call your doctor immediately if you get a second shock within 24 hours.

What will it be like if the ICD shocks me in public?

People who see you get shocked might not be aware of what’s going on. But they may see you startle or jerk. And, of course, they will notice if you pass out. If you are awake, you will probably want to explain to them what happened. 

What will happen if I get shocked and I am alone?

If you fainted or blacked out before the shock you may have fallen, so you should make sure you didn’t injure yourself. Otherwise, there are no particular concerns about being alone when you are shocked.

What should I tell my family and close friends about having an ICD?

You’ll probably want to give them an overview of what an ICD is and why you have one in case they observe you getting shocked. “The most important thing for them to know is that if you are shocked more than once, or if you are shocked and afterward you still are not feeling well, then they should call 911 to get you to the hospital,” Dr. Rowan said.

You can download this wallet card from the AHA so people can access your doctor’s name, contact information and details about your device if they need to. 

Can I go through a metal detector with an ICD? 

Your ICD will set off a metal detector, so in airports or other situations where you need to pass through one, you should request a pat-down instead. (The metal detector will detect the ICD but won’t damage it.) You can use your wallet card to identify yourself as a person with an ICD. The full body scanners that are available at some airports are safe to go through with an ICD. 

Magnets and strong electrical fields may interfere with your ICD. You’ll need to take precautions if you have other surgeries or need MRI scans. ICDs aren’t all the same, so if you have questions about the restrictions of your device, ask your health care team. “You can always call your cardiologist’s office and talk to a nurse if you have concerns,” Schminke said.

What else should I know about living with an ICD?

When you receive an ICD, it’s normal to have anxiety and experience depression. Reach out to your primary care provider or cardiologist if you would like a referral to a behavioral health specialist. Your cardiologist’s office may also be able to connect you with a support group for people with ICDs and their family members. 

The bottom line

If you need an ICD, it’s normal to feel nervous and anxious about living with the device and to have questions about what it will be like. Talk to your cardiologist and your health care team to learn more about what you can do and how you can continue your activities with an ICD. If you would like to connect with a heart health expert, reach out to Banner. 

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