Implantable Cardiac Defibrillator (cont.)
What are the complications of ICD implantation?
Common complications include pain, swelling, and minor
bleeding at the implantation site. More serious
complications are uncommon and typically occur less than 2%
of the time. Serious complications include major bleeding
requiring blood transfusions, introduction of air into the
space between the lung and chest wall (pneumothorax)
requiring tube drainage, perforation of the heart muscle by
the leads, activation of an intractably fast heart rhythm,
stroke, heart attack, need for emergency heart surgery, and
death. Although there are no official guidelines, ICDs
should be implanted by or in conjunction with a
cardiologist specially trained in clinical cardiac
electrophysiology (electrical diseases of the heart).
What happens during a tachycardia
episode after implantation of an ICD?
When the heart is beating normally, the ICD remains
inactive. When tachycardia occurs, the patient typically
experiences the symptoms of a fast heart rate. Since
tachycardia can lower blood pressure and cause dizziness or
fainting spells, the person should lie down or sit down
until the symptoms pass. The ICD will either send a series
of pacemaker-like weak electrical signals or one or more
low energy shocks to convert the tachycardia to normal
rhythm. The patient may not feel the pacemaker-like
signals, while the low energy shocks may feel like thumps
in the chest. Terminating a tachycardia with low energy
shocks is called cardioversion.
If ventricular fibrillation occurs, the patient may
suddenly feel faint or lose consciousness due to lack of
blood pressure and blood supply to the brain. The ICD,
sensing the rapid and irregular rhythm, quickly sends a
strong shock to terminate the rhythm. Terminating
fibrillation with a strong electric shock is called
defibrillation. Successful defibrillation promptly restores
consciousness. If unconsciousness lasts longer than 30
seconds, emergency 911 should be called.
The patient, or anyone available to assist, should also
call emergency (911) if any of the following occur:
- Symptoms of tachycardia persist after feeling the shock(s);
- Symptoms of tachycardia persist and the patient feels no shocks (possible ICD malfunction); or
- The patient feels a series of shocks in a row (possible ICD malfunction or recurrent attacks of tachycardias). Both conditions need prompt medical attention.
Next: Living with an ICD. »
- Pacemaker - Learn about the pacemaker - an electronic device used to treat patients with abnormally slow or irregular heartbeats on MedicineNet.com
- Low Blood Pressure - Learn about low blood pressure (hypotension). Low blood pressure is blood pressure below normal and symptoms may include: lightheadedness, dizziness, fainting upon standing (orthostatic hypotension). There are many causes of low blood pressure, and treatment is dependant upon the cause.
- Electrocardiogram (ECG or EKG) - Read about the Electrocardiogram (ECG, EKG) procedure used to reflect underlying heart conditions such as agnina, occurance of a prior heart attack or of an evolving heart attack, and more.
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