A subcutaneous implantable defibrillator is a small battery-powered device with one electrode wire that runs along the breastbone and down towards the left side of the chest under the skin. It provides protection for a broad range of patients at risk for sudden cardiac death while also providing protection from the risks and complications associated with transvenous leads.
1In a life-threatening situation, the device works by sending an electrical shock to your heart to restore normal heart rhythm.
The procedure for installing your S-ICD is not as complex as you might think.
The procedure starts with an intravenous line (IV) being placed into a vein in your arm. This is for the medical team to administer medication during or after your procedure. You will receive an antibiotic to prevent an infection of your new S-ICD. A sedative will also be given. The implant can be performed under general anaesthetic, local anaesthetic or alternatively a regional nerve block.
Your Doctor will make incisions on the left side of your chest or under your left arm. They insert the generator next to your rib cage, under your skin and inside fat. Then they tunnel the lead under your skin to the middle of your chest near your breastbone, then up toward your neck.
During the procedure, your doctor will be able to see the lead using x-ray imaging. Once your doctor has positioned the lead correctly, the lead and the S-ICD will be tested to make sure they are working properly. Then your skin will be closed using dissolving sutures.
You will not be able to drive a vehicle for two weeks after having an S-ICD installed. You will also need to limit your arm movement on the side of your defibrillator as much as possible during those first two weeks to allow the S-ICD wires to settle.
About two weeks after your procedure, you will have a clinic appointment where a pacing technician will check your defibrillator and your doctor will remove the wound dressing.
You will then need follow-up appointments on a regular basis at the clinic or through our remote home monitoring service. We will check the operation of your S-ICD and review any abnormal heart rhythms stored on the device.
Any kind of procedure carries some element of risk, often very small and rare.
Your doctor has balanced the benefits and risks of carrying out the test against the benefits and risks of not proceeding. If your doctor has recommended this procedure, they believe there is benefit to you going ahead.
It’s important you understand the risks involved so you can make an informed decision.
Here are the most commonly reported risks and complications associated with an SICD installation.
Common risks and complications (more than 5% of cases)
- Bruising and bleeding in the S-ICD pocket
Uncommon risks and complications (1-5% of cases)
- The ICD’s lead can move-the lead will need to be put back in place by repeating this procedure
- Pocket infection
Rare risks and complications (less than 1% of cases)
- Punctured lung or pneumothorax
- Lead Fracture
- Battery issues
- Blood clot in the lung or pulmonary embolism (PE)
- Heart attack
- Stroke
- Death from any complications
