How are patients with an implantable cardioverter-defibrillator (ICD) resuscitated?

Updated: Oct 11, 2019
  • Author: Daniel M Beyerbach, MD, PhD; Chief Editor: Jeffrey N Rottman, MD  more...
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If a patient enters a life-threatening cardiac arrhythmia, advanced cardiac life support (ACLS) protocols should be initiated immediately. Although an implantable cardioverter-defibrillator (ICD) will attempt defibrillation, chest compressions should be continued. Note that some of the current may enter the rescuer; aside from some mild discomfort, however, there has never been a reported case of rescuer injury from this. [45]

Ventricular tachycardia (VT) and ventricular fibrillation (VF) refractory to ICD defibrillation will require external defibrillation and/or antiarrhythmic medications as dictated by ACLS protocols. If external defibrillation is required, attempt to keep the generator at least 10 cm away and out of the shock wave. Defibrillation that affects the generator may cause total device failure. However, do not withhold therapy for fear of damaging the ICD.

If rescuers are uncomfortable with ICD discharge during resuscitation, deactivation of the ICD with a magnet is indicated.

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