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ICDs are programmed to pick up and stop life-threatening arrhythmias
ICDs are life-saving devices, similar to pacemakers. They are programmed to pick up and stop specific life-threatening arrhythmias (abnormal heart rhythms) and restore your heart to its normal rhythm.
An ICD consists of a small 'box' with pacing wires which are situated within the chambers of your heart and provide information about your heart's rhythm. An ICD is fitted in the same way as a pacemaker.
ICDs can be used:
There are two types of arrhythmia that are treated with ICDs:
If you have heart failure you may need a special type of device called a CRT-D (cardiac resynchronisation therapy defibrillator) device. As well as treating heart arrhythmias, a CRT-D device also synchronises your heart's chambers to contract and relax in a regular way, thus improving the pumping action of your heart.
An ICD can work like a basic pacemaker to stabilise your heart's rhythm and / or cardiovert (correct abnormal heart ryhthm) your heart through the delivery (or 'firing') of a controlled electrical 'shock'. This process, called defibrillation, stops a dangerous arrhythmia and allows the normal rhythm of your heart to start again. Sometimes this is simply referred to as your ICD 'firing'.
Each device is programmed, specifically, to respond to your individual needs. The programme can be modified if necessary. Depending on your heart rate, an ICD can:
You will need some tests and investigations to help your cardiologist (heart doctor) to decide if an ICD will help you. These may include:
More advanced tests, such as an Adenosine Test and Electrophysiology (EP) studies, may sometimes be needed.
If your cardiologist feels that an ICD would be helpful to you then he / she will explain to you about your arrhythmia and why you need to have an ICD. You may want to talk about:
At the end of life an ICD could keep your heart beating artificially. This can be the case for both heart and non-heart related conditions or when your quality of life has become very poor. For some people there comes a point when the decision needs to be made as to whether an ICD is still appropriate. The decision to turn off an ICD can be very difficult and should involve discussions with close family and your doctor / specialist nurse.
Turning off an ICD is a simple, non-invasive procedure, which can be performed by a cardiac physiologist (technician). It is important to know that specialised care will be provided to support you if the decision to switch off your ICD is made. Specialised care, referred to as palliative care, ensures that all your needs will be met and that you and your family are well supported.