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What is an ICD?

An ICD (implantable cardioverter defibrillator) is an electronic device that is designed to monitor your heart rate and rhythm. If your heart beats with a very fast or very slow rate in an abnormal pattern, an electrical jolt is delivered to the heart muscle to restore normal rate and rhythm. The implantable device originated from the use of external defibrillators that shocks the heart with leads on the skin. 

 

Why is an ICD needed? 

Ventricular tachycardia or VT (incredibly fast heart beats) and ventricular fibrillation or VF (unproductive fluttering of the heart) are two life-threatening heart rhythms that cause the heart to beat very fast. These conditions can lead to sudden cardiac death (SCD) if not treated immediately.

If you have experienced at least one of these arrhythmias or your heart has other underlying risk factors for heart disease you are at a high risk having future occurrences of these arrhythmias that can lead to SCD. Your doctor will recommend ICD in order to prevent potential SCD.

Who needs an ICD? 

  • Had a prior episode of sudden cardiac arrest
  • Had a prior episode of ventricular fibrillation
  • Had at least one episode of ventricular tachycardia
  • Had a prior heart attack and have an increased risk for sudden cardiac arrest or sudden cardiac death
  • Have hypertrophic cardiomyopathy

 

Who is not a good candidate for an ICD?

  • Patients with ventricular tachyarrhythmias due to a completely reversible disorder in the absence of structural heart disease (eg, electrolyte imbalance, drugs, or trauma).
  • Patients who do not have a reasonable expectation of survival with an acceptable functional status for at least one year, even if they otherwise meet ICD implantation criteria.
  • Patients with incessant ventricular tachycardia (VT) or ventricular fibrillation (VF).
  • Patients with significant psychiatric illnesses that may be aggravated by device implantation or that may preclude systematic follow-up.
  • Patients with syncope without inducible ventricular tachyarrhythmias and without structural heart disease.

 

References 

Cleveland Clinic – Implantable Cardioverter Defibrillator (Cleveland Clinic) http://my.clevelandclinic.org/heart/services/procedures/icd.aspx

General principles of the implantable cardioverter-defibrillator (UptoDate) http://www-uptodate-com.proxy.westernu.edu/contents/general-principles-of-the-implantable-cardioverter-defibrillator source=machineLearning&search=Implantable+Cardioverter+Defibrillator&selectedTitle=1%7E150&sectionRank=1&anchor=H2#H179461098

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