During surgery to insert an implantable cardioverter defibrillator, the doctor uses a local anesthetic to numb the insertion site, according to Johns Hopkins Medicine. After making a small incision, the doctor inserts a plastic tube into the blood vessel, then guides in the ICD lead wire and advances it until it is at the heart. After testing for correct placement, he inserts the ICD generator just under the incision, checks the wire connections and device function, then closes the site.
Depending on the patient's medical condition and other factors, he may have the surgery on an outpatient basis or may remain in the hospital. Prior to the procedure, the patient must remove all jewelry and put on a gown, and receives an intravenous line to deliver fluids and sedative medication throughout the surgery, explains Johns Hopkins. The patient also remains hooked up to an electrocardiogram monitor and has careful monitoring of his other vital signs during the ICD insertion.
Doctors typically use an area just above the collar bone for the insertion site, cleaning the area with antiseptic prior to making an incision. Patients may need up to three lead wires, depending on the device the doctor implants, says Johns Hopkins. The site for the ICD generator is usually an area just below the collar bone. Following implantation, the doctor seals the incision site using stitches, adhesive strips or glue, and then applies a sterile bandage.