The device sits over or under the muscle on the left side of the chest. We attach it to one or two leads that we pass down via a vein at the top of your chest into the heart. One lead goes into the bottom chamber of the heart (the ventricle), and if needed, another sits in the top chamber of the heart (the atrium).

The device monitors your heart continuously for potentially dangerous heart rhythms. If it detects one of these rhythms, the device can deliver a small electric shock which can restore the heart to its normal rhythm.

Two types of ICD:

• Transvenous ICD – We insert this device in the upper chest and pass leads down the veins into the heart.
• Subcutaneous ICD – We bury the leads and device under the skin of the chest. There are no leads in the heart at all.

We will discuss the risks and benefits of the two types with you and together decide which device is right for you.

It depends on which type of ICD you need. The procedure is usually straightforward and performed as a day case. We use either a local anaesthetic and sedation (medicine which makes you sleepy) or a general anaesthetic.

We make a small incision in the upper chest and a pocket under the skin for the generator or battery. We pass one or two leads through a vein in the chest that runs down into the heart. We position the leads in the heart. One end is then attached to a generator placed on top or below the muscle in the chest. We close the wound with sutures (stitches).

If you need a subcutaneous ICD (S-ICD), we use a general anaesthetic (i.e. you will be asleep). Beforehand, you will have an assessment to ensure that this type of device is suitable for you.

Unlike a transvenous ICD, the lead from an S-ICD is not inside the heart. But simply under the skin of your chest. We then connect the lead to a generator buried above the chest muscle.

Depending on the sutures we use, you may need them removed in 7-10 days. The hospital staff will advise you if and when you need to have your sutures removed. You will also receive a card explaining which device you have and when and where it was placed. You must carry this card with you at all times.

Some heart conditions/issues that commonly cause breathlessness include:

The wound should take a couple of weeks to heal. At least for the first week, you must keep the wound clean and dry to minimise the chances of an infection. If you have a transvenous ICD, don’t lift your left (or right if the device is right-sided) arm above your shoulder for at least six weeks.

The lead takes this long to “bed in” and become fixed. If you lift your arm too soon, you could dislodge the ICD lead from its position. This could mean that the device can’t monitor your heart rhythm or can’t deliver a shock effectively. If this happens, you may need another procedure to reposition the lead.

You will not be able to drive for some time after the procedure and must inform the DVLA. How long you can’t drive depends on the reason you need the device.

The ICD battery (or generator) will last around 7-10 years. After this time, it will need replacing; this is a straightforward procedure. The leads can stay in as long as they’re working effectively. Most leads never need replacing and last the rest of your life.