Preparation
Dr. Moore will recommend an implantable cardioverter-defibrillator (ICD) if you are prone to certain types of arrhythmias, especially those that could cause sudden cardiac arrest. The ICD is a small electronic tool that will be inserted under the skin near your heart. Leads on the ICD will be connected to your heart, and if the ICD detects an abnormal rhythm, it will shock your heart back to a normal rhythm. Some ICD's are equipped with pacemaker abilities so they can 'pace' your heart's rhythm too.

A battery that will last many years before it needs to be replaced will power your ICD. Once your ICD is inserted, you'll have it checked at least twice per year to ensure that it's functioning properly. Dr. Moore is involved in a newly developed program to evaluate the ICD over the telephone line via a secure web site that allows him to examine the function of your device on his computer.

Dr. Moore performs ICD implants at Indian River Memorial Hospital. To prepare for this procedure, you must:

• Inform Dr. Moore if you may be pregnant
• Abstain from eating or drinking at least six to eight hours prior to the test

Procedure
Once you have registered, changed into a hospital gown, and been situated in bed, you'll receive an intravenous (IV) line that will be used to administer a mild sedative that will help you relax during the procedure. You'll still be awake and somewhat responsive during the procedure, but many patients find they don't remember much afterwards. Electrodes will be attached to your chest to monitor your heart, and a cuff will be placed on your arm to monitor your blood pressure.

Once you have been sedated, the cardiologist will make an incision on the left side of your chest. This incision will create a small pouch for the ICD. Next, the cardiologist will use fluoroscopy, a special x-ray technique that captures and stores images in real-time, to guide the ICD leads and properly place them in your heart. The leads are then attached to the ICD generator and the ICD is inserted into the pouch. The small incision is closed with stitches. The implantation generally takes about an hour.

Post-procedure
You'll usually be required to spend the night in the hospital, so the cardiac team can monitor your heart and ensure the device is working properly. After the procedure, a follow-up appointment with Dr. Moore will be scheduled. Resume your normal medication schedule as instructed by Dr. Moore.

For the most part, patients with ICD's can resume a normal life. Unnecessary shocks to the heart are the most common complication of an ICD implant. While the shock doesn't last a long time, you'll feel it. If you receive a shock, notify your cardiologist.

Like a pacemaker implant patient, you also should carry an official device card in your wallet that indicates that you have an ICD. Some security systems, such as at the airport, may detect your ICD. You should also inform all of your physicians and dentist of your device. Lastly, most electronic equipment does not interfere with ICD, but some especially strong electrical and magnetic devices can disrupt the way the ICD works. Be aware of your surroundings, and if you have questions, ask your cardiologist.