Day of ICD placement
Informed by recognized medical guidance
Overview
An ICD (implantable cardioverter-defibrillator) placement is a surgery where a small device is put under your skin near your collarbone. The device watches your heart rhythm and delivers a small shock to restore a normal rhythm if a dangerous fast rhythm (arrhythmia) happens.
Key facts
- The procedure is done under local anesthetic and sedation, so you are asleep and feel no pain.
- Most people stay in the hospital overnight and go home the next day.
- The device is tested during the procedure to make sure it works properly.
It is a common procedure for people at risk of sudden cardiac arrest. Thousands of ICDs are placed each year.
People who have had a heart attack, have heart failure, or have certain genetic heart conditions that cause dangerous heart rhythms.
Symptoms
- Chest pain that does not go away
- Sudden severe shortness of breath
- Fainting and not waking up quickly
- Feeling of a fast, fluttering heartbeat that lasts more than a few minutes
- ⚠New or worsening palpitations
- ⚠Dizziness that makes you feel you might fall
- ⚠Swelling in your legs or ankles
Common symptoms
- Fainting or near fainting (syncope)
- Palpitations (feeling like your heart is racing or fluttering)
- Shortness of breath
- Chest discomfort or pain
Symptoms in children
- Fainting during exercise
- Feeling tired or weak
- Rapid heartbeat
Symptoms in older adults
- Dizziness or light-headedness
- Confusion
- Shortness of breath with activity
Causes
Main causes
- Damage to the heart muscle from a heart attack
- Heart failure that weakens the heart's pumping ability
- Genetic conditions that cause abnormal heart rhythms, such as long QT syndrome or Brugada syndrome
Risk factors
- Previous heart attack
- Family history of sudden cardiac death
- Heart failure with reduced ejection fraction (a measure of how well your heart pumps)
When to see a doctor
See a doctor urgently if:
- If you have any of the emergency symptoms listed above, call your local emergency number immediately.
Book a routine appointment if:
- If you have been diagnosed with a condition that puts you at risk for dangerous arrhythmias, talk to your cardiologist about whether an ICD is right for you.
Diagnosis
Your doctor will decide if you need an ICD based on your medical history, symptoms, and results from heart tests.
Tests that may be done
- Electrocardiogram (ECG) – a recording of your heart's electrical activity
- Echocardiogram – an ultrasound of your heart to see how well it pumps
- Holter monitor – a portable ECG you wear for 24–48 hours
- Electrophysiology study – a test where thin wires are threaded into your heart to check its electrical system
What to expect at your appointment
Before the procedure, you will meet with your cardiologist and anesthesiologist. You will be asked to not eat or drink for several hours before surgery. The procedure takes 1–2 hours. You will be given medicine to make you sleepy, and the area near your collarbone will be numbed.
Treatment
The main treatment is placing the ICD. The device is connected to the heart with wires (leads) and can deliver a shock to reset the heart rhythm if needed.
Self-care at home
- Follow your doctor's instructions about eating and drinking before the procedure.
- Arrange for someone to drive you home after discharge.
- Tell your healthcare team about all medicines you take, including over-the-counter ones.
Medical treatments
Your doctor may prescribe medicines to manage your heart condition, such as beta blockers or other heart rhythm medicines. These are given to reduce the chance of dangerous arrhythmias. Always take them exactly as prescribed.
When is surgery considered?
ICD placement is itself a surgery. It is done in a hospital operating room or catheterization lab.
Living with this condition
After the procedure, keep the incision area clean and dry for about a week. Avoid heavy lifting or strenuous activity for 4–6 weeks. You will have a follow-up appointment to check the device.
Lifestyle tips
- Avoid contact sports that could hit your chest (e.g., football, boxing).
- Keep cell phones at least 6 inches away from the ICD site.
- Tell all healthcare providers you have an ICD before any medical procedure.
- Carry an ID card or wear a medical alert bracelet showing you have an ICD.
Diet and exercise
Most people can return to normal daily activities after recovery. Walking is encouraged. Talk to your doctor before starting new exercise routines.
Mental health and emotional wellbeing
Some people feel anxious about shocks or worry about the device. This is normal. Counseling or support groups can help.
Prevention
An ICD does not prevent arrhythmias from happening, but it treats them quickly to prevent sudden cardiac arrest.
Vaccines
It is important to stay up to date with recommended vaccines, especially flu and pneumonia vaccines, to avoid infections that could stress your heart.
Screening programmes
If you have a family history of sudden cardiac death or certain genetic heart conditions, your doctor may recommend genetic testing or screening ECG for family members.
Complications
If left untreated
- Without an ICD, a life-threatening arrhythmia can cause sudden cardiac arrest and death.
- Fainting spells may occur without warning.
Long-term outlook
The outlook for people with an ICD is very good. The device saves lives by stopping dangerous rhythms. Most people live full, active lives with regular check-ups. Your doctor will program the device to match your needs.
Find support
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
Related conditions
Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 18, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.