Implantable Cardioverter Defibrillator (ICD) Implantation

An implantable cardioverter defibrillator (ICD) is a small battery-powered device placed in your chest to constantly monitor your heart rhythm and immediately deliver electric shocks when life-threatening arrhythmia is discovered, usually when the lower left chamber of the heart beats abnormally fast. The implantable cardioverter defibrillator (ICD) helps normalize heart rhythm. This type of arrhythmia can lead to death due to heart attack. The implantable cardioverter defibrillator (ICD) can also stimulate the heart when it beats too slowly.

The Implantable Cardioverter Defibrillator (ICD) Components

1.    A pulse generator, which is a tiny computer powered by battery.

2.    One or two leads, wires that deliver electrical signals between the pulse generator and the heart.

3.    Electrodes at the ends of the leads, to help deliver the signals when the device detects abnormal heart rhythms. The generator will send electrical signals to the heart to return to normal rhythm.

  1. Please avoid food and water for at least eight hours before the procedure.
  2. ​Please let the doctor know about all medication that you are taking as some may need to be stopped before the procedure.
  1. You will receive intravenous fluids and medication.
  2. During the procedure your vital signs and blood pressure will be monitored.
  3. You will be given a sedative and/or anesthesia from the anesthesiologist so you are asleep during the procedure.
  4. The doctor will administer a local anesthetic before placing the leads, which are small wires, through a blood vessel, inserting them through an incision made in the skin under the collarbone. The other end of the wire will be attached to the pulse generator.
  5. Once the device has been placed, the doctor will check that it is functioning properly and will program it in accordance with your condition.
  6. The implantation of the implantable cardioverter defibrillator (ICD) takes approximately two hours.

1.    You will be moved to the Cardiac Care Unit (CCU) where you will stay for one night to be closely monitored. You will spend one to two nights in the regular inpatient ward so the doctor can check your heart rhythm and make sure the device is working properly.

2.    You may experience some pain and swelling in the area where the device was placed.

3.    You will be asked to avoid raising the arm above the shoulder on the side of the implantation, strenuous activity, and heavy lifting for about one month after the surgery.

4.    Please see your doctor immediately if you experience electrical shocks more than once a day.

5.    During your regular check-ups, your doctor will check the battery in your device, which should last up to seven years. When the battery needs to be replaced, the procedure is relatively minor compared to the initial surgery.


  1. Bleeding or hematoma, and infection where the implantable cardioverter defibrillator (ICD) was implanted.
  2. Allergic reaction to the medications used during the procedure.
  3. Damage to blood vessels.
  4. Bleeding in the pericardium.
  5. The implantable cardioverter defibrillator (ICD) sends abnormal signals to the heart or malfunctions or the leads come loose.
  6. Stroke, heart attack, or other serious complications, which are uncommon.
  7. Death (rare).
Let your doctor know if you develop problems, such as:
  1. Bleeding, swelling or increased pain at the implantation site
  2. Fever
  3. Dizziness
  4. Fainting
  5. Chest pain
  6. Difficulty breathing

Before the Procedure

·        You should plan to stay in Thailand for at least one to two weeks through the duration of your treatment.

·        It is recommended that you stay in a hotel close to the hospital for convenience in traveling to the hospital before and after the procedure or from the day of the procedure to the day of your follow-up appointment.

After the Procedure

·        At your follow-up appointment you will undergo a physical examination and your wound will be checked. You will receive documentation regarding your surgery or procedure and all other relevant documentation for traveling.

·        Avoid lifting your left arm higher than your shoulder for at least one month after the procedure. You may swing your arms normally.

·        Avoid getting the incision wet for at least one week or as recommended by the doctor or until your doctor schedules a follow-up appointment to check your incision. You may wipe yourself down with a wash cloth or sponge during this time.

·        The incision site may be bruised, which is normal after the procedure. The bruise will resolve on its own within two weeks. If a hematoma develops or if there is uncontrolled bleeding from the incision or if the site shows signs of inflammation, such as swelling, redness, warmth, and/or severe pain, please see your doctor immediately.

·        If you develop a fever or if you become lightheaded or faint, please see your doctor immediately to determine the cause of these symptoms.

·        Before you are discharged the doctor will change your bandage, which can be removed after one week or at your follow-up appointment to check the wound. The incision will be covered with a paper or thin tape after that. Do not remove it. The tape will slowly dissolve when you bathe.

·        You can use a mobile phone normally, but please carry it in hand on the opposite side of the implantable cardioverter defibrillator (ICD). Avoid carrying your phone in your shirt pocket as pockets are usually at chest level, which brings the phone close to the implantable cardioverter defibrillator (ICD).

·        Always carry your implantable cardioverter defibrillator (ICD) card to provide preliminary information to any doctor that you see if you must travel to another province or country. Show the implantable cardioverter defibrillator (ICD) card when you go through airport check points with metal detectors as the implantable cardioverter defibrillator (ICD) may show up as suspicious and set off alarms because of the metal it is made with.

·        When traveling by air, if you are seated in Economy Class, please choose an exit row or bulkhead seat for convenience in getting up and moving around every 15-30 minutes. Flex your ankles regularly to prevent deep vein thrombosis.

·        Please take all medication prescribed by your doctor. Carry the appropriate dosage of mediation in your carry-on luggage when you travel as well as a few extra doses in case of an emergency. Carry the prescription for all your medication to avoid problems at the airport.

The success of the procedure depends on a number of factors. Please discuss the likelihood of success with your doctor before the procedure.
What if this procedure is not performed?
The implantation of an implantable cardioverter defibrillator (ICD) can save the life of a patient that needs it when a life-threatening arrhythmia occurs. When the heart beats abnormally, blood is not efficiently pumped to the various parts of the body. The patient can lose consciousness and may even die without immediate treatment.


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