Cardioverter defibrillator (ICD) insertion involves the surgical placement of a small, electronic device used to regulate and continuously monitor the electrical activity of the heart. Its job is to deliver an electrical shock to the heart when the heart rate becomes dangerously fast (fibrillates). It can also record and store information about the heart rhythm for the physician to review.
An ICD insertion may be recommended for survivors of sudden cardiac arrest, some inherited heart problems, or conditions that cause the heart to beat too fast or too irregular, causing symptoms such as fatigue, dizziness, fainting, and/or chest pain.
an ICD is a little larger than a typical pacemaker or about the size of a stop watch and is usually inserted under the skin in the upper chest. It consists of a battery and tiny computer (pulse generator) and wires (leads).
The Cooper Heart Institute has a large and renowned team of physicians who offer world class cardiac care and have extensive experience performing cardioverter defibrillator insertion surgery.
Understanding the procedure
A surgeon/interventional cardiologist from the Cooper Heart Institute will make a small incision beneath the collarbone and make a small pocket under the skin to hold the defibrillator. The pacemaker will be inserted through this incision. Generally, it is placed on the non-dominant side, meaning in a left-handed person, the device will be placed in the upper right chest.
The wires will be threaded through a vein under the collarbone to the heart. Once the lead wire is inside the heart, it will be tested to verify proper location and that it works. There may be one, two, or three lead wires inserted, depending on the type of device. A special type of x-ray displayed on a TV monitor (fluoroscopy) may be used to assist in testing the location of the leads.
Local anesthesia will be used, meaning that only the area being operated on is numbed.