ICDs
An ICD or implantable cardioverter defibrillator is a life saving device which can deliver a shock to/cardiovert the heart to restore sinus rhythm from dangerous arrhythmias.
A subcutaneous implantable cardioverter-defibrillator (S-ICD) is a less invasive alternative to a traditional ICD. A doctor places the S-ICD device under the skin at the side of the chest below the armpit. The device connects to a sensor, called an electrode, which runs along the breastbone.
Some ICDs have a pacing function so they can help keep the heart rhythm regular but also be there to restart the heart if the rhythm goes out.
In infants and small children, an ICD is too large to be implanted under the collarbone or beneath the armpit. It is usually paced in a pocket behind the muscle of the abdomen. The only issue is that there is a great length of wire from the heart to the stomach and it is the wire which is the most vulnerable part of an ICD. The actual device itself is fairly robust, however, in the tummy it doesn’t have the protection that it does behind the collarbone.
An ICD is a device reserved for the most at risk patients as they, like pacemakers, have their own risks and problems. They used to be given to Long QT patients quite readily, but it many cases, they might be actually overkill and not really ever required.