An implantable cardioverter defibrillator (ICD) is a battery-powered device similar to a pacemaker that is placed under the skin in the chest. An ICD is composed of two parts: a pulse generator and one or more leads (thin wires). The leads run from the pulse generator to positions most often inside the heart, but occasionally on its outer surface. The leads are most often implanted by a physician through blood vessels in a minimally invasive procedure. In a standard pacemaker (PCM), the leads monitor the heart rhythm and can deliver a small electrical impulse to “pace” the heart if it is going too slowly. An ICD also does this and, additionally, can deliver a higher energy electric shock to restore the normal rhythm in the event of a rapid, life-threatening rhythm.
ICDs are typically used to correct heart rhythm disorders (cardiac arrhythmias), including fast arrhythmias such as ventricular tachycardia or ventricular fibrillation. ICDs can also function as a pacemaker by delivering an electrical signal to regulate a heart rate that is too slow (bradycardia).
Cardiac specialists at the Brigham and Women’s Hospital (BWH) Heart & Vascular Center are experienced in using ICD devices for their patients. In fact, BWH physicians were involved in implanting the first ever transvenous ICDs and have been actively involved in their evolution over the past 20 years. This experience, and their collaboration with a multidisciplinary team of specialists through the Cardiac Arrhythmia Service, enables our physicians to handle the most complicated cases.
With 47,000 outpatient visits each year, the Heart & Vascular Center is one of the largest in the United States, treating over 7,000 inpatients and performing more than 8,000 procedures annually at our state-of-the-art Shapiro Cardiovascular Center.
An ICD may be inserted in patients with the following:
The Heart & Vascular Center is located in the Shapiro Cardiovascular Center, across the street from BWH’s main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of services in one location, fostering seamless and coordinated care for all cardiovascular patients.
Prior to the procedure, you will be scheduled for a visit to the Watkins Clinic in the Shapiro Cardiovascular Center for preoperative information and tests.
The day of the procedure, your care will be provided by cardiologists, anesthesiologists, technicians and nurses who specialize in ICD insertion surgery. The procedures are performed in the state-of-the-art Electrophysiology Laboratory at Brigham and Women’s Hospital.
The procedure usually takes one to two hours depending on the type of ICD you are receiving. During the procedure local anesthesia will be used to anesthetize the surgical site, and you will receive intravenous medications to keep you comfortable. The devices are most often implanted in the left or right upper chest under the skin.
You will recover in the Cardiovascular Recovery Room (CVRR) where you will receive comprehensive care by an experienced surgical and nursing staff. While in the CVRR, you will receive education about your new device (you will have also received this material prior to the procedure) and someone will answer any questions you may have. You will also be provided with a remote monitor which can check your device from home and send us the information. There is a good chance you will be able to go home the same day as the procedure. If that is the case, we will check your device via the remote monitor the following day and someone from our team will call to check on you.
During your procedure, family and friends can wait in the Shapiro Family Center where staff members will provide surgery updates.
Patients benefit from the teamwork of surgeons, cardiologists, interventional cardiologists, cardiovascular imaging experts and radiologists, and anesthesiologists, all experts in implantable cardioverter defibrillator (ICD) devices. They work alongside nurses, physician assistants, physical therapists, dietitians and social workers to achieve outstanding outcomes for our patients.
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Learn about the Watkins Clinic in the Shapiro Cardiovascular Center.
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