Implantable Cardioverter Defibrillator is a small device that is powered by a battery, and it is placed in the chest or abdomen area near the collarbone. The device can be lifesaving in patients who are at risk of sustained ventricular tachycardia, fibrillation, or heart attack. What is more, the device works continuously for 24 hours, and it detects any abnormal heartbeat (arrhythmia) and at the same time, monitors the heart rhythm.

Furthermore, to fix any unusual heart rhythm and to restore the natural rhythm of the heart, ICD sends an electric shock through the wires that have been connected to the heart. ICDs have been one of the most useful devices in preventing sudden deaths in patients who have shown susceptible symptoms to heart failure.

Moreover, the device acts just like an electrified paddle when a patient loses consciousness due to cardiac arrest but with the difference that the shock is applied internally. Implantable Cardioverter Defibrillator can be programmed to send low or high energy which depends on the severity of the heart condition.

The right candidates for Implantable Cardioverter Defibrillator are patients with sustained ventricular tachycardia and ventricular arrhythmia. However, patients can also benefit from ICD if they are having the following symptoms:

• A weakened heart due to a history of a heart attack. 
• Abnormal or enlarged heart muscles. 
• Abnormal heart beating because of inherited heart defects. 

In order to realize if a patient needs ICD, the doctor will take several diagnostic tests:

• Electrocardiography (ECG):  In this test, the doctor will measure electrical impulse in the heart. 
• Echocardiography: This is a noninvasive test that allows the doctor to use sound waves to see the natural rhythm of the heart. 
• A Holter monitor:  The test will run for 24 hours to record a patient heart rhythm. 

The implantation of ICD is performed with sedative medication to make patients feel relaxed, but they are awake during the procedure. ICD is a pulse generator that is often implanted in the chest. During the surgery, insulated wires (leads) that are thin and flexible will be inserted through the collarbone and will be guided toward the heart.

Additionally, the procedure uses an X-ray to help the doctor with the threading of the wire in attaching one end to the heart and the other end to a generator. To test if the ICD is functional and program it to fit each patient’s heart rhythm, the doctor may induce the heart speed and then will bring it back to normal with a shock.

• Infection at the area where ICD has been implanted. 
• Allergic reaction to mediation. 
• Swelling, bleeding, or bruising at the implant site. 
• ICD leads may, in some cases, damage the veins. 
• Leakage of the blood through the heart in the area of ICD implantation. 

ICD is a surgery that requires patients to follow doctor’s instructions vigorously. The doctor will strongly recommend following the below recommendation:

• Refrain above-the-shoulder activities, like driving, swimming, bowling, or cleaning.
• Patients should not lift any heavy objects
• Electrical inference can be problematic with the function of the ICD therefore, below precautions should be taken:
  • Avoid placing the cellphone near the ICD.
  • Patients who have performed ICD has a special card, and they should show it to airport gate security if they want to travel with an airline.
  • MRI or MRA are not recommended.
  • Avoid wearing headphones.
• It is best advised that patients do not drive for at least six months after ICD.

Implantable Cardioverter Defibrillator is an innovative solution that has substantial benefits for patients who are suffering from arrhythmia. The first ICD implantation in 1980 has dramatically changed the condition of cardiac care. Over the years, the introduction of ICD in Iran has opened the door to new alternative treatments in people with cardiac arrest. Many Iranian cardiologists have seen successful results with the ICD implantation in treating abnormal heartbeat or preventing life-threatening circumstances. Moreover, Iran has shown a promising outcome, in terms of both improving hospital facilities and reducing mortality risks of patients who were at imminent risk. Iran is using cutting-edge technologies to provide patients who have chosen Iran as their medical destination the best available treatment, offering the most advanced and efficient ICD devices that can ensure the most desirable outcome.