Your doctor may recommend a defibrillator implant if you have a high risk of a life-threatening heart arrhythmia. This includes people who have had: 

  • A heart attack and are at high risk for sudden cardiac death
  • Episodes of any serious heart arrhythmia, such as a rapid atrial fibrillation. This is a rapid quivering of the upper chambers of the heart.
  • Hypertrophic cardiomyopathy, a complex heart disease characterized by thickened heart muscle and ventricular stiffness
  • Sudden cardiac arrest and survived
  • Ventricular tachycardia. A single episode of ventricular tachycardia can warrant an implantable defibrillator.

Your doctor may also recommend a defibrillator implant for warning signs seen on heart tests. These heart tests include electrocardiography (ECG), ultrasounds, stress tests, and a catheter electrophysiology study.

Who performs a defibrillator implant?

A cardiac surgeon performs a defibrillator implant. Cardiac surgeons specialize in the surgical treatment of conditions of the heart and its blood vessels. Cardiac surgeons may also be known as cardiothoracic surgeons.

How is a defibrillator implant performed?

Your defibrillator implant will be performed in a hospital. The procedure takes a few hours and generally includes these steps:

  1. You will dress in a patient gown and lie on a procedure table.
  2. Your team will insert an intravenous (IV) line to provide fluids and medications.
  3. You will have medication (a sedative) to relax you. You may fall asleep.
  4. A team member will prepare an area of your chest or abdomen (belly). This includes shaving if needed, cleaning, and covering with a surgical drape. This is the area where your surgeon will place your defibrillator.
  5. Your surgeon will numb the area with an injection of local anesthetic. You will not feel anything in the area where your surgeon places the defibrillator.
  6. Your surgeon will thread the wires of your defibrillator through a vein to your heart using real-time X-ray guidance. 
  7. Once the wires are in place, your surgeon will make a cut in either your chest or your abdomen and place the pulse generator.
  8. Your surgeon will test the pulse generator once everything is connected. Your team will give you more medication to put you in a deeper sleep when the pulse generator is tested. You will not feel the any electrical pulses during the test.
  9. After the surgeon has tested the defibrillator, the skin will be closed with stitches, tape or glue.

Will I feel pain?

Your comfort and relaxation is important to you and your care team. You may feel a pinch or prick when the IV is inserted and stinging when the local anesthetic is injected. Your doctor will give you sufficient sedative medications so that you are comfortable. Tell your doctor if you are uncomfortable in any way.

What are the risks and potential complications of a defibrillator implant?  

As with all surgeries, a defibrillator implant involves risks and possible complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.  

General risks of surgery 

The general risks of surgery include: 

  • Adverse reaction or problems related to sedation or medications, such as an allergic reaction and problems with breathing 
  • Bleeding, which can lead to shock
  • Blood clot, in particular a deep vein thrombosis that develops in the leg or pelvis. A blood clot can travel to your lungs, heart or brain and cause a pulmonary embolism, heart attack, or stroke.
  • Infection and septicemia, which is the spread of a local infection to the blood

Potential complications of a defibrillator implant

Complications of a defibrillator implant include:

  • Blood clots or air bubbles in the vein
  • Collapsed lung
  • Defibrillator malfunction requiring your doctor to reprogram it or replace it
  • Heart or nerve damage
  • Punctured heart or lung
  • Tearing an artery or vein
  • Unnecessary electrical pulses (impulses). This occurs when the defibrillator sends pulses that are not needed. This can damage your heart, cause irregular heart rhythms and pain, and be emotionally upsetting. It is the most common complication of a defibrillator implant.