What Happens Before and After ICD Surgery for Arrhythmias?

Living with arrhythmias can feel unsettling, especially when the risk of sudden cardiac arrest becomes a concern. For many patients, an Implantable Cardioverter Defibrillator (ICD) offers reassurance and life-saving protection. But undergoing ICD surgery can also raise many questions. Patients often wonder what the preparation involves, what to expect during the procedure, and how life changes afterward. Understanding the journey before and after ICD surgery helps patients feel more confident and prepared for this important step.

Understanding ICD Surgery

An ICD is a small device implanted under the skin, usually near the collarbone, to monitor and regulate heart rhythm. Unlike a pacemaker, which only corrects slow heart rates, an ICD can deliver electrical shocks or pacing therapies to stop dangerously fast or chaotic heart rhythms.

ICD surgery involves placing this device inside the body, with leads connected to the heart. Once in place, it continuously tracks the heart’s activity and responds instantly when it detects arrhythmias that could lead to cardiac arrest.

Before ICD Surgery: Preparing for the Procedure

1. Medical Evaluation

Before ICD surgery, patients undergo a detailed medical assessment. This may include:

• Electrocardiogram (ECG): To study heart rhythm patterns.
• Echocardiogram: To check heart function and pumping ability.
• Stress tests: To see how the heart reacts under physical exertion.
• Blood tests: To rule out other health issues before surgery.

Doctors also review medications and medical history to ensure the patient is a good candidate for the procedure.

2. Discussion with the Cardiologist

The cardiologist explains the purpose of the ICD, how it works, and what patients can expect. This is an important time to ask questions and clear doubts about the device, surgery, or long-term care.

3. Pre-Surgery Instructions

Patients are usually advised to:

• Avoid eating or drinking for several hours before surgery.
• Stop certain medications such as blood thinners if recommended.
• Arrange transportation, as driving immediately after the procedure is not possible.

4. Emotional Preparation

It is natural for patients to feel anxious before ICD surgery. Understanding that this device is a safety net—designed to protect against life-threatening arrhythmias—often helps ease stress. Support from family, friends, and healthcare professionals also plays a vital role.

During the Procedure: What Happens in the Operating Room

ICD surgery is typically performed in a cardiac catheterization lab or an operating theater under local anesthesia and sedation. Patients remain awake but relaxed, and the surgical team monitors vital signs throughout.

The steps usually include:

1. A small incision is made near the collarbone.
2. Leads are guided through a vein into the heart.
3. The ICD device is connected to the leads and placed under the skin.
4. The system is tested to ensure it detects and corrects abnormal rhythms effectively.
5. The incision is closed with sutures or surgical glue.

The entire procedure usually takes 1–2 hours, and most patients do not require an overnight hospital stay unless other health conditions are present.

After ICD Surgery: The Recovery Phase

1. Immediate Recovery

After surgery, patients are observed for a few hours to ensure the ICD is working properly. Discomfort or swelling at the incision site is common, but pain is usually mild and manageable. Patients may be discharged the same day or the following morning.

2. Wound Care and Activity Restrictions

• Keep the incision clean and dry.
• Avoid lifting heavy objects for a few weeks.
• Refrain from raising the arm on the side of the implant above shoulder level until cleared by the doctor.
• Watch for signs of infection such as redness, swelling, or unusual discharge.

3. Adjustment Period

Patients may feel the device beneath their skin, but with time, they usually adapt and hardly notice it. In some cases, patients may be startled if the ICD delivers a shock, but this is a sign that the device is doing its job—preventing dangerous arrhythmias.

4. Follow-Up Appointments

Regular check-ups are critical after ICD surgery. Doctors review device function, battery health, and any arrhythmia episodes recorded. Most ICDs also allow remote monitoring, so doctors can track performance without frequent hospital visits.

Long-Term Life After ICD Surgery

Resuming Daily Activities

Within a few weeks, patients can return to most normal activities, including walking, working, and light exercise. However, strenuous activities or contact sports may be restricted to avoid damage to the device.

Travel and Lifestyle

Most patients with ICDs can travel safely, including flying. However, they should always carry a medical ID card and inform airport security about the device. Certain electrical equipment and strong magnetic fields may interfere with ICDs, so precautions are advised.

Emotional Well-Being

Living with an ICD may bring emotional adjustments. Some patients feel anxious about shocks, while others feel reassured by the protection. Counseling, support groups, and open discussions with healthcare providers can help manage these feelings.

Device Longevity

ICDs typically last 5–10 years before battery replacement is needed. Replacement is a simpler procedure than the initial implantation.

Why Choose Expert Care for ICD Surgery?

The success of ICD surgery depends on expert evaluation, precise implantation, and long-term care. At The Heartae, patients benefit from advanced cardiac technology, skilled specialists, and comprehensive support throughout the journey. From initial consultation to aftercare, the focus is always on safety, comfort, and improving quality of life for individuals living with arrhythmias.

Conclusion

ICD surgery is more than just a medical procedure—it’s a protective measure that saves lives by preventing sudden cardiac arrest. Before surgery, patients undergo thorough evaluations and preparations to ensure safety. After surgery, careful recovery, regular follow-ups, and lifestyle adjustments help individuals return to normal life with confidence. With expert guidance and modern technology, patients can embrace a future with greater peace of mind, knowing their heart is safeguarded every second.