Receiving an ICM, Pacemaker or ICD Device
Before you have your insertable cardiac monitor (ICM), pacemaker or implantable cardioverter defibrillator (ICD) procedure, it is important that you understand what the procedure can involve.
Generally, risks depend on your age, general health, specific medical condition and heart function.
A small percentage of patients may develop complications from the implant surgery, including:
- Lead dislodgement, if you receive a pacemaker with leads
- A reaction to the device or a drug used
- Internal tissue damage
In addition, many people have a small scar after the incision heals and a small bump where the implanted device rest in your chest. If you are very small or thin, the bump may be more pronounced. If you are concerned about this, your doctor may be able to place your device in a place that is less noticeable.
Insertion and implant procedure
Insertable cardiac monitor
To place the Confirm Rx™ ICM, your doctor will perform a minimally
invasive procedure. Inserting the ICM typically involves these steps:
- Your doctor makes a small incision in the pectoral region.
- Using the insertion tool, your doctor will ensure the preloaded device is positioned correctly.
- Your doctor will then press the plunger until the device is inserted and then remove the insertion tool.
- Your doctor will program the device with the Merlin™ Patient Care System and then close the incision.
For most people, the procedure is done under local anesthetic around the incision area. The actual procedure should take less than 10 minutes, and you should not have to be monitored overnight.
Pacemaker with leads or ICD implant
If you doctor determines you will need a general anesthetic for your procedure, an anesthesiologist will give you medications to put you to sleep. Most patients stay awake during the procedure, and receive a local anesthetic to numb the area where the device will be implanted. If you receive the local anesthetic, you may be able to hear and even talk with the medical team during the procedure, and team members may have instructions for you, too. During the procedure, you may feel some pressure while the team implants your device, but you should not feel any pain.
Implanting a pacemaker or ICD typically follows these steps:
- Your doctor makes a small cut in your upper chest and locates a vein.
- Your doctor makes a small puncture in the vein, and guides the leads down the vein to your heart.
- The surgical team monitors the lead placement in your heart using a kind of X-ray machine called a fluoroscope.
- Once the leads are in place, your doctor tests them to make sure they are in the best position to deliver energy to your heart.
- Your doctor might ask you to go through some simple maneuvers, such as taking a deep breath or coughing vigorously, to make sure the leads are stable.
- Your doctor creates a “pocket” by making a small incision (cut) in the skin and separating the underlying tissue from the muscle beneath it.
- The surgical team connects the device to the leads and places it in the pocket.
- The team closes the incision.
The duration of the surgery depends on what kind of device you are getting, as well as your specific anatomy and the time it takes to locate a good position for the lead. In some cases, implanting a pacemaker or ICD can take a number of hours.
Immediately after the procedure
After the procedure, you will go to a recovery room to be monitored. You may feel some discomfort, and you will be tired. Depending on your condition, you may stay in the hospital from several hours up to several days. Your doctor will tell you how long to expect to stay.