ICDs are implanted in a very similar way to pacemakers. The main differences are the size and characteristics of the leads and the size and shape of the ICD generator. ICD leads are usually slightly thicker than pacing leads. This is because they contain coils to deliver a shock to the heart as well as the components to pace the heart. ICD leads can have one or two shocking coils. The number of coils required is usually dependent on the size and function of your heart. The larger size of the ICD generator means it is more frequently placed below the chest muscle than pacemakers.
Checking the ICD after implantation
Unlike most current pacemakers, modern ICDs can communicate with an ICD programmer wirelessly if within a few metres of the patient. Although this makes checking the ICD a little bit easier when having a physical ICD check, it really comes into its own with remote monitoring. Patients can choose to have their ICD monitored remotely, again with a device provided which plugs into a telephone line at home. However, unlike a pacemaker, the ICD communicates wirelessly with this device several times a day and will transmit information every night. This means that whenever there is a problem with the ICD or if it has delivered a shock, it will transmit that information to a remote sever. This, in turn, will be notified to me via email by the next working day. This provides greater peace of mind for patients with ICDs and alerts me to problems much more quickly than normal. If you do not wish to have remote monitoring, you will need at least two physical ICD checks each year.