You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
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3Your |
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6Your Summary |
An
When you have heart failure, the lower
The heart may beat so fast that the ventricles don't have time to fill with blood. This type of abnormal rhythm is called ventricular tachycardia (say "ven-TRICK-yuh-ler tack-ih-KAR-dee-uh"). Some types of ventricular tachycardia may lead to ventricular fibrillation (say "ven-TRICK-yuh-ler fib-ruh-LAY-shun"). With ventricular fibrillation, the heart quivers, or flutters, and stops pumping blood. Then, if the heart stops beating, this is called cardiac arrest. Cardiac arrest causes sudden death.
An ICD is a battery-powered device that can fix an abnormal heart rhythm and prevent sudden death.
An ICD is always checking your heart rate and rhythm. If the ICD detects a life-threatening rapid heart rhythm, it may try to slow the rhythm back to normal using electrical pulses. If the dangerous rhythm does not stop, the ICD sends an electric shock to the heart to restore a normal rhythm. The device then goes back to its watchful mode.
Some ICDs also can fix a heart rate that is too slow without using a shock. The ICD can send out electrical pulses to speed up a heart rate that is too slow.
Whether you get pulses or a shock depends on the type of ICD, the type of heart problem that you have, and the way the doctor programs the ICD to respond to it.
In some people who have heart failure, the ventricles don't beat at the same time. If these people also have a risk for abnormal heart rhythms, they may get a device that combines an ICD and a biventricular (say "by-ven-TRICK-yuh-ler") pacemaker. This pacemaker is also called cardiac resynchronization therapy (CRT). This type of pacemaker uses electrical pulses to make the ventricles pump at the same time. The ICD part of the device can give a shock to fix an abnormal heart rhythm.
Your doctor will put the ICD in your chest during minor surgery. You will not have open-chest surgery. You probably will have local anesthesia. This means that you will be awake but feel no pain. You also will likely have medicine to make you feel relaxed and sleepy.
The doctor will make an incision (cut) in the skin just below your collarbone or at the side of your chest. The doctor will put the ICD leads (wires) through the cut. For one type of ICD, your doctor puts one or two leads in a large blood vessel and threads them into the heart. For another type, the lead may be placed under the skin through a small cut in the middle of your chest. Then your doctor connects the leads to the ICD. Your doctor puts the ICD under the skin of your chest and closes the cut. Your doctor also programs the ICD.
Most people spend the night in the hospital, just to make sure that the device is working and that there are no problems from the surgery.
You may be able to see a little bump under the skin where the ICD is placed.
The shock from an ICD hurts briefly. It's been described as feeling like a punch in the chest. But the shock is a sign that the ICD is doing its job to keep your heart beating. You won't feel any pain if the ICD uses electrical pulses to fix a heart rate that is too fast or too slow.
There's no way to know how often a shock might occur. It might never happen.
It's possible that the ICD could shock your heart when it shouldn't. If that were to happen, you would have pain. The shock could make you fall out of bed, and that could injure you. You also might be afraid or worried about when the ICD might shock you again.
In rare cases, the shock could cause ventricular fibrillation. If this happened, the ICD would shock your heart again to stop the abnormal rhythm.
Many people say that they have a good quality of life with an ICD. But shocks—and the fear of shocks—can make some people worry too much. They may be afraid all the time that the ICD might shock them. This worry can reduce a person's quality of life.
An ICD often is placed in people with heart failure who have survived a dangerous abnormal rhythm. The ICD would protect them if they get another abnormal heart rhythm.
But it also may be offered to people with heart failure who haven't had an abnormal heart rhythm but are at risk for one.
You will have tests to see whether you are at risk for abnormal heart rhythms. These may include an electrocardiogram (EKG, ECG), an echocardiogram, or an electrophysiology study.
Your doctor will use these test results and your medical history to figure out if an ICD could help you. Your doctor also will rely on guidelines that help find out who might benefit from an ICD.
Your personal feelings are just as important as the medical facts. Talk with your doctor about what matters most to you.
Your doctor may talk with you about a few things. These include whether:
An ICD can prevent sudden death from an abnormal heart rhythm. ICDs may also help certain people who have heart failure live longer. How much an ICD might help you depends on a few things, including your overall health. Your doctor can help you understand how well an ICD might help you.
There are several risks to getting an ICD. But the risks are different for each person. The risks also depend on the type of ICD that you get. Your doctor can help you understand what your risks are from an ICD.
During the procedure. Problems can happen during or soon after the procedure to implant an ICD. Here are some examples.
After the procedure. Problems can also happen months or years after the ICD is implanted. These problems are related to the device or the leads.
After the ICD is implanted, you will not drive for a short time. Depending on the reason you got the ICD, you may not be able to drive for one week to a few months. If you get a shock from the ICD, your doctor may ask that you don't drive for a short time.
You'll need to take steps to safely use electric devices. Some electric devices have a strong electromagnetic field. This field can keep your ICD from working right for a short time. Check with your doctor about what you need to avoid and what you need to keep a short distance away from your ICD. Many household and office electronics do not affect your ICD.
You will need regular monitoring and checkups with your doctor to make sure that the ICD is working well and that the programming is right for you.
It's important to keep taking your medicines for heart failure. You'll also need to follow a healthy lifestyle to treat heart failure. This includes eating healthy foods that are low in salt and not smoking.
An ICD runs on a battery that can last several years. If the battery gets low, you can decide whether or not to have minor surgery to replace the ICD.
Talk with your doctor about the possibility of turning off the ICD at the end of life. Many people consider turning off the ICD when their health goals change from living longer to getting the most comfort possible at the end of life. Turning off your ICD is legal. It isn't considered suicide. The decision to leave on or turn off your ICD is a medical decision that you make based on your values.
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These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I've had heart failure for a while now. My ejection fraction is 40%. It's not great. But my doctor says it's not low enough for me to think about getting an ICD. I'm taking my heart failure medicine, eating a low-salt diet, and doing everything my doctor says to do. If my ejection fraction gets lower, I will think about getting an ICD.
Marie, age 71
About 6 months ago I had a heart attack. It affected my heart's ability to pump. So I have heart failure. I've had some trouble just going shopping and taking walks. My doctor and I agreed that I should get an ICD. The type I'm going to get combines a pacemaker for heart failure and an ICD.
Lucy, age 55
My doctor said I could get an ICD. We talked about how it could help me. But I don't want a device like that inside my body. So I'm not going to get one.
Martin, age 75
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to get an ICD
Reasons not to get an ICD
I want to do everything I can to prevent a deadly heart rhythm.
I would rather use only medicine to lower my chance of a deadly heart rhythm.
I'm not worried that the ICD might shock me.
I would worry all the time that the ICD might shock me.
I don't mind having a device inside my body.
I don't like the idea of having a device inside my body.
I'm not worried about the risks of surgery.
I'm concerned that something could go wrong with the surgery.
I'm not concerned about long-term risks.
I'm concerned about long-term risks.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Getting an ICD
NOT getting an ICD
Check the facts
Decide what's next
Certainty
1. How sure do you feel right now about your decision?
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
| Author | |
|---|---|
| Clinical Review Board | All Ignite Healthwise, LLC education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals. |
An
When you have heart failure, the lower
The heart may beat so fast that the ventricles don't have time to fill with blood. This type of abnormal rhythm is called ventricular tachycardia (say "ven-TRICK-yuh-ler tack-ih-KAR-dee-uh"). Some types of ventricular tachycardia may lead to ventricular fibrillation (say "ven-TRICK-yuh-ler fib-ruh-LAY-shun"). With ventricular fibrillation, the heart quivers, or flutters, and stops pumping blood. Then, if the heart stops beating, this is called cardiac arrest. Cardiac arrest causes sudden death.
An ICD is a battery-powered device that can fix an abnormal heart rhythm and prevent sudden death.
An ICD is always checking your heart rate and rhythm. If the ICD detects a life-threatening rapid heart rhythm, it may try to slow the rhythm back to normal using electrical pulses. If the dangerous rhythm does not stop, the ICD sends an electric shock to the heart to restore a normal rhythm. The device then goes back to its watchful mode.
Some ICDs also can fix a heart rate that is too slow without using a shock. The ICD can send out electrical pulses to speed up a heart rate that is too slow.
Whether you get pulses or a shock depends on the type of ICD, the type of heart problem that you have, and the way the doctor programs the ICD to respond to it.
In some people who have heart failure, the ventricles don't beat at the same time. If these people also have a risk for abnormal heart rhythms, they may get a device that combines an ICD and a biventricular (say "by-ven-TRICK-yuh-ler") pacemaker. This pacemaker is also called cardiac resynchronization therapy (CRT). This type of pacemaker uses electrical pulses to make the ventricles pump at the same time. The ICD part of the device can give a shock to fix an abnormal heart rhythm.
Your doctor will put the ICD in your chest during minor surgery. You will not have open-chest surgery. You probably will have local anesthesia. This means that you will be awake but feel no pain. You also will likely have medicine to make you feel relaxed and sleepy.
The doctor will make an incision (cut) in the skin just below your collarbone or at the side of your chest. The doctor will put the ICD leads (wires) through the cut. For one type of ICD, your doctor puts one or two leads in a large blood vessel and threads them into the heart. For another type, the lead may be placed under the skin through a small cut in the middle of your chest. Then your doctor connects the leads to the ICD. Your doctor puts the ICD under the skin of your chest and closes the cut. Your doctor also programs the ICD.
Most people spend the night in the hospital, just to make sure that the device is working and that there are no problems from the surgery.
You may be able to see a little bump under the skin where the ICD is placed.
The shock from an ICD hurts briefly. It's been described as feeling like a punch in the chest. But the shock is a sign that the ICD is doing its job to keep your heart beating. You won't feel any pain if the ICD uses electrical pulses to fix a heart rate that is too fast or too slow.
There's no way to know how often a shock might occur. It might never happen.
It's possible that the ICD could shock your heart when it shouldn't. If that were to happen, you would have pain. The shock could make you fall out of bed, and that could injure you. You also might be afraid or worried about when the ICD might shock you again.
In rare cases, the shock could cause ventricular fibrillation. If this happened, the ICD would shock your heart again to stop the abnormal rhythm.
Many people say that they have a good quality of life with an ICD. But shocks—and the fear of shocks—can make some people worry too much. They may be afraid all the time that the ICD might shock them. This worry can reduce a person's quality of life.
An ICD often is placed in people with heart failure who have survived a dangerous abnormal rhythm. The ICD would protect them if they get another abnormal heart rhythm.
But it also may be offered to people with heart failure who haven't had an abnormal heart rhythm but are at risk for one.
You will have tests to see whether you are at risk for abnormal heart rhythms. These may include an electrocardiogram (EKG, ECG), an echocardiogram, or an electrophysiology study.
Your doctor will use these test results and your medical history to figure out if an ICD could help you. Your doctor also will rely on guidelines that help find out who might benefit from an ICD.
Your personal feelings are just as important as the medical facts. Talk with your doctor about what matters most to you.
Your doctor may talk with you about a few things. These include whether:
An ICD can prevent sudden death from an abnormal heart rhythm. ICDs may also help certain people who have heart failure live longer. How much an ICD might help you depends on a few things, including your overall health. Your doctor can help you understand how well an ICD might help you.
There are several risks to getting an ICD. But the risks are different for each person. The risks also depend on the type of ICD that you get. Your doctor can help you understand what your risks are from an ICD.
During the procedure. Problems can happen during or soon after the procedure to implant an ICD. Here are some examples.
After the procedure. Problems can also happen months or years after the ICD is implanted. These problems are related to the device or the leads.
After the ICD is implanted, you will not drive for a short time. Depending on the reason you got the ICD, you may not be able to drive for one week to a few months. If you get a shock from the ICD, your doctor may ask that you don't drive for a short time.
You'll need to take steps to safely use electric devices. Some electric devices have a strong electromagnetic field. This field can keep your ICD from working right for a short time. Check with your doctor about what you need to avoid and what you need to keep a short distance away from your ICD. Many household and office electronics do not affect your ICD.
You will need regular monitoring and checkups with your doctor to make sure that the ICD is working well and that the programming is right for you.
It's important to keep taking your medicines for heart failure. You'll also need to follow a healthy lifestyle to treat heart failure. This includes eating healthy foods that are low in salt and not smoking.
An ICD runs on a battery that can last several years. If the battery gets low, you can decide whether or not to have minor surgery to replace the ICD.
Talk with your doctor about the possibility of turning off the ICD at the end of life. Many people consider turning off the ICD when their health goals change from living longer to getting the most comfort possible at the end of life. Turning off your ICD is legal. It isn't considered suicide. The decision to leave on or turn off your ICD is a medical decision that you make based on your values.
| Get an ICD | Don't get an ICD | |
|---|---|---|
| What is usually involved? |
|
|
| What are the benefits? |
|
|
| What are the risks and side effects? |
|
|
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I've had heart failure for a while now. My ejection fraction is 40%. It's not great. But my doctor says it's not low enough for me to think about getting an ICD. I'm taking my heart failure medicine, eating a low-salt diet, and doing everything my doctor says to do. If my ejection fraction gets lower, I will think about getting an ICD."
— Marie, age 71
"About 6 months ago I had a heart attack. It affected my heart's ability to pump. So I have heart failure. I've had some trouble just going shopping and taking walks. My doctor and I agreed that I should get an ICD. The type I'm going to get combines a pacemaker for heart failure and an ICD."
— Lucy, age 55
"My doctor said I could get an ICD. We talked about how it could help me. But I don't want a device like that inside my body. So I'm not going to get one."
— Martin, age 75
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to get an ICD
Reasons not to get an ICD
I want to do everything I can to prevent a deadly heart rhythm.
I would rather use only medicine to lower my chance of a deadly heart rhythm.
I'm not worried that the ICD might shock me.
I would worry all the time that the ICD might shock me.
I don't mind having a device inside my body.
I don't like the idea of having a device inside my body.
I'm not worried about the risks of surgery.
I'm concerned that something could go wrong with the surgery.
I'm not concerned about long-term risks.
I'm concerned about long-term risks.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Getting an ICD
NOT getting an ICD
1. I'll feel a painful shock if an ICD fixes a heart rhythm that could cause sudden death.
2. If the battery gets low, I will need to decide whether to have surgery again to replace the ICD.
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
| By | |
|---|---|
| Clinical Review Board | All Ignite Healthwise, LLC education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals. |
Current as of: July 31, 2024
Author:
All Ignite Healthwise, LLC education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
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