Implantable Cardioverter Defibrillator (ICD) Implantation (Endocardial Approach)


In this procedure, a small device called an electrical impulse generator is implanted in the chest to monitor and regulate the rhythm of the heart. When the device detects a certain type of irregular heartbeat, called an arrhythmia, the impulse generator sends electrical impulses through one or more wire leads to the heart muscle. These impulses are designed to correct the heart's rhythm.


In preparation for the procedure, the patient is positioned and the surgical site on the chest is numbed with local anesthesia. The patient generally receives sedation. The patient is attached to monitors and equipment that will track and regulate the patient's heartbeat, blood pressure and oxygenation level during the procedure.

Implanting the Leads

First, the physician will implant the leads. The physician makes one or more small incisions in the chest to access a large vein in the chest. The physician will push a wire lead through this vein and, with the aid of an x-ray device called a fluoroscope, carefully guide it into the heart. More than one lead may be placed in various chambers of the heart, depending on the patient's need.

Implanting the Impulse Generator

When the leads are in position, they are connected to the impulse generator. Small impulses of electricity are sent through the leads to the heart to test the device. Once the device is working correctly, the physician slips the generator beneath the skin of the chest and closes the incision.

End of Procedure and Aftercare

When the procedure is complete, the patient is taken to a recovery room. The patient will be closely monitored in the facility for one or two days to confirm that the device is working correctly before being discharged. The doctor will provide specific instructions for care and maintenance of the device.