Living with an Implantable Cardioverter Defibrillator (ICD)
Patients all over the world are being fitted with implantable cardioverter defibrillators (ICDs) to treat conditions ranging from irregular heart rhythms and heart failure to cardiac arrest.
An implantable defibrillator, commonly known as an ICD, is a device implanted in your body that is designed to provide life-saving therapy in the event of sudden cardiac arrest. ICD devices have been used for decades and have prolonged hundreds of thousands of lives. Today, there are two types of Boston Scientific ICDs being implanted: 1) the transvenous ICD system and 2) the subcutaneous ICD (S-ICD™) System. Both types of ICDs can deliver defibrillation therapy. However, the S-ICD system does not place an electrical wire in your heart.
Boston Scientific encourages you to discuss any concerns about your implantable cardioverter defibrillator (ICD) device with your healthcare provider. This will help you develop a good understanding of your heart condition. Other topics you may want to discuss include any medications you take, when you can return to work, and exercise.
The Patient Experience
Michael Sorrell, ICD Patient
"People talk about being in service or being a servant leader to others, but they often take it for granted that they will get those opportunities. If my life had ended back in September when this happened, I would have left an incomplete book. I want at the end of my time to leave the best, most complete book that I can.”
See Michael's Story >>
Jan Visser, S-ICD System Patient
"My heart may be weaker than it should be but I am sure that faith and optimism will keep me going for a while. The S-ICD feels already like a part of my body, and I have more confidence in life and in the future.”
Read Jan’s story >>
Lizzie and Michael Garcia, ICD Patients
"The morning of Halloween 2007, I woke up to go put on my costume to get ready for school and I got really dizzy and I blacked out. But before I even came back, my ICD had gone off. It saved me.”
Learn about the Garcia's and other young ICD patients >>
Select the topics below to learn how the ICD works, and tips to adjusting to your device over time. The Implanted Device Checklist includes general recommendations. Your healthcare provider may have guidelines that are more specific for you.
- Implanted Device Checklist >>
- Adjusting to Life with ICD Therapy >>
- Preparing for ICD Shock Therapy >>
- Device Checks and Follow-ups >>
- Replacing your ICD Device >>
ICD devices are recommended for patients who have survived or at risk of experiencing sudden cardiac arrest (SCA). SCA can strike without warning. Often people who experienced it felt fine moments before.
- Coronary artery disease – About 90% of adult victims of SCA have plaque in two or more major heart arteries (coronary arteries).1
- Heart Attack – About 75% of sudden cardiac arrest victims have scarring in their heart muscle from a prior heart attack.1
- Other heart problems – When SCA occurs in young adults other rare heart conditions are likely the cause, such as hypertrophic cardiomyopathy and long QT syndrome.1
Implanted Device Checklist
After recovering from the procedure, you should be able to continue to enjoy travel or exercise to improve the health of your heart. With the added protection against sudden cardiac arrest, the ICD system will give you peace of mind to live your life to the fullest, do the things you enjoy, and spend valuable time with the ones you love.
- At all times, carry your patient ID card with you for emergency reference. This ID card lets people know you have an ICD system and provides implanted device, implant date, and physician information.
- Take the medications prescribed for you as instructed by your healthcare provider.
- Visit your healthcare provider or pacemaker clinic for regular checkups. During these routine visits, your doctor may adjust the settings of the ICD system using a wireless programmer.
- Be sure to consult your doctor on what to do if you receive a shock. While the shock may be uncomfortable and startling, it means that the ICD system may have detected a dangerously fast heart rhythm and delivered the defibrillation therapy you needed to restore your heart to a normal rhythm.
- Be sure to carry your card to tell your family doctor, dentist, and emergency personnel that you have an implanted device.
With your new ICD system and the guidance of your healthcare provider, you should soon return to your normal activities. For most people, work, hobbies, sexual activity, travel, and other parts of their lifestyle are no different once they have an ICD device. Your ICD will help you enjoy as active and productive a lifestyle as your overall health permits.
Adjusting to life with an ICD System
It is natural to feel anxious about the device at first. You have experienced something new and very stressful – an event that changed your thoughts and feelings about your health. It may take days to weeks to up to a year for you to feel somewhat back to normal.
Having the ICD system is positive because it can treat your arrhythmias. However, some people feel vulnerable because they depend on an implanted device. The good news is those feelings generally do not last. As you return to daily life, your level of confidence and comfort with the ICD device will grow.
Many patients find that encouraging friends and family to learn about the ICD system is helpful as well.
Michael Sorrell, SCA Survivor - Watch the Video [00:55]
"I feel like I have a second chance. That means that every day you get a chance to make people’s lives a little better than they were the day before.” Michael Sorrell
Remember that your ICD device is designed to monitor and treat your life-threatening arrhythmias. It can be a great source of reassurance for you and your friends and family.
Preparing for ICD Shock Therapy
You will not feel any physical sensations while the device monitors your heart. However, shock therapy for an arrhythmia may be very noticeable. It is important that you know what to expect.
Before you experience symptoms or receive shock therapy, it is important to have a plan for contacting emergency personnel and your heart doctor.
If you have symptoms of a fast heart rate, it is likely that the ICD system will deliver therapy within a few seconds. There usually is not much time to react.
- Try to remain calm…or lie down in case you lose consciousness.
- The sensation from receiving therapy should only last a moment.
All ICD devices deliver high-energy shocks to dangerous heart rhythms. The shock comes quickly and lasts only a second. Some patients remain awake and describe the shock as a "kick in the chest" or a “punch in the back.” Many patients are unconscious shortly after a fast VT or VF rhythm begins and do not feel the shock. While many find the shock reassuring, other patients may be upset for a short time after the shock is delivered.
An episode for Ventricular Fibrillation treated with shock therapy.
The ICD device automatically records what happened when your heart rhythm becomes abnormal. Your doctor can see what happened and, if needed, adjust the settings on the device.
ICD Therapy - Watch the Video [00:28]
It is possible that you could feel symptoms and not receive therapy. This depends on the programmed settings of your ICD system.
- Exercise may cause shortness of breath, dizziness, or lightheadedness.
- An abnormal heart rhythm may cause symptoms that your ICD system is not programmed to treat.
If symptoms are severe or continue for more than a minute or so, you should seek immediate medical attention. Be sure to talk with your healthcare provider about what you should do.
“I've probably had about 20 shocks in my life so far, but I still remember my first shock. For the first time, I realized that I actually felt safe after an arrhythmia instead of scared that I might die.” Matt Nobel
Device Checks and Follow-ups
Your doctor will schedule regular follow-up visits. Most ICD patients have their devices checked every 3 months. Your healthcare provider may call this a device check, interrogation, or follow-up visit.
There are two follow-up options: in-office visits and remote follow-up sessions.
In-office follow-up visits
Your healthcare provider will schedule regular in-office follow-up visits. A typical follow-up visit takes about 20 minutes. It is important that you attend these visits, even if you are feeling well.
During your visit, your healthcare provider will use a computer-like device, called a programmer, that "talks" to the ICD with radio signals. They will review your device's memory and check for any arrhythmia events you may have had. If necessary, they will adjust your device's programmed settings. They will also check the battery to see how much energy is left.
If you have a transvenous ICD, a device implanted near your collarbone with leads that connect the device to your heart muscle, your device may be followed away from the office using the equipment sent to your home. If you have an S-ICD System, your device does not have remote follow-up capabilities.
A remote follow-up session is done away from the office using the equipment sent to your home.
- You will receive a home monitoring unit called a Communicator that sends information through either a standard telephone line or cellular connection.
- The Communicator is used to interrogate your device on a schedule that is set by your healthcare provider.
- Information from your device is sent to a secure website that only your healthcare support team can view.
For Boston Scientific patients, information from your device is sent to the LATITUDE Patient Management system secure website for access by your doctor.
Note: The home monitor cannot reprogram or change any functions of your device. Your healthcare provider can only do this using a programmer during an in-office visit.
You may have some follow-up visits done in the office, and others done at home with the remote monitoring system.
Replacing Your ICD Device
In addition to checking the system's function, your healthcare provider will check the energy in the ICD battery. A battery, safely sealed inside your device, provides the energy needed to monitor your heart rhythm and treat arrhythmias when they occur. The ICD has a replacement indicator that helps your healthcare provider determine when to schedule a new device.
To replace your ICD, your doctor will surgically open the pocket of skin where your device is located. Your old device is disconnected from your leads and then the leads are checked to make sure they work properly with your new device. In rare instances, your leads may not work properly with your new device, and your doctor may need to replace the leads.
Be sure to talk with your doctor about the potential risks when making decisions about replacing your system.
Other helpful information can be found in these sections:
- Heart Attack
- Ventricular Tachycardia
- Implantable Cardioverter Defibrillator (ICD) Device Implantation
- Implantable Cardioverter Defibrillators (ICDs) from Boston Scientific (Product Info)
Individual symptoms, situations, circumstances, and results may vary. Please consult your physician or qualified health care provider regarding your condition, appropriate medical treatment. The information provided is not intended to be used for medical diagnosis or treatment or as a substitute for professional medical advice.