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Dr. Sunil Agarwal

AICD Implantation


An implantable cardioverter defibrillator (ICD or AICD) is a permanent device in which a lead (wire) inserts into the right ventricle and monitors the heart rhythm. It is implanted similar to a single chamber pacemaker and the generator lays in the upper chest area and venous access is through the subclavian vein. Therapies are delivered in the form of anti-tachycardia pacing (ATP) or shocks to convert to sinus rhythm from sustained ventricular tachycardia or ventricular fibrillation, both of which are life-threatening rhythms.

For primary prevention of sudden cardiac death, ICDs are indicated:

1) Patients with a prior myocardial infarction and a left ventricular ejection fraction of < 30% (MI must have been at least 40 days prior in order to allow time for recovery of LV systolic function).
2) Patients with systolic heart failure (New York Heart Association functional class II or III) and an ejection fraction < 35%. Optimal medical therapy must be present and at least 3 months must have elapsed in case the systolic function recovers to an ejection fraction > 35% in both non-ischemic cardiomyopathy patients and ischemic cardiomyopathy patients who underwent bypass surgery.

  • For secondary prevention of sudden cardiac death, ICDs are indicated:

    Patients with documented cardiac arrest from sustained ventricular tachycardia or ventricular fibrillation or documented hemodynamically stable sustained ventricular tachycardia even if the left ventricular ejection fraction is > 35%, as long as no reversible cause is identified. The above must not be within 48 hours of an acute coronary syndrome.

    • Syncope
    • Interventricular septal thickness of 30 mm or greater
    • Documented ventricular tachycardia and/or cardiac arrest
    • Family history of sudden cardiac death
    • Left ventricular systolic dysfunction in the setting of wall thinning (a.k.a. "burnt out" left ventricle)

  • The doctor will make an incision in your upper chest area below the collarbone. A wire will be inserted through a vein into your heart. Sometimes more than one wire is used. The doctor will create a “pocket” in your chest, where the AICD is inserted.

  • The automatic implantable cardioverter-defibrillator (AICD) is a device designed to monitor the heartbeat. This device can deliver an electrical impulse or shock to the heart when it senses a life-threatening change in the heart’s rhythm.

  • An Automatic Implantable Cardioverter Defibrillator, (AICD), is a small electronic device that is implanted into your chest to monitor and correct an abnormal heart rhythm, or arrhythmia. These devices are used to treat serious and life-threatening arrhythmias and are the most effective way of doing so.