About to get an ICD

Hey all, I was diagnosed with VT about a month ago, and my EP is going to do an EP study and, if I'm a good candidate, an ICD implant all the same day. It is AMAZING to find a community like this!

My questions:

1. Anyone else here have both the study and implant done at the same time?

2. I am VERY active as a formerly competitive cyclist, though now just recreational (cardiologist-recommendation to not push it as hard as you have to when competitive). I am also an avid multi-day backpacker. What brought me here was a "hmm, I wonder..." moment about wearing a 25-35 pound backpack, and how the strap may interact with the ICD. Anyone else out there with experience on that?

3. I've read about sub-pec implants, and that sounds intriguing. I am a thin endurance athlete with very low body fat, so a big bulge, especially one that could move around, doesn't excite me. Any recommendations?

4. If a sub-pec implant happens, it sounds like a replacement can be challenging for another EP. Any experience there?

5. As with many active and/or competitive cyclists, I have had a collarbone-fracture repaired with a titanium strap that was bolted to my left clavicle. Anyone else out there with this? Wonder if it affects the how the ICD gets implanted. I'd doubt it, but it's worth asking.

5. On the topic of replacements, how long do these things last? I've heard 3-7 years, and wonder if that's partially due to how active they are, and how quickly the battery gets drained.

Thank you all, and I'll report back after my procedure (scheduled for June 16th, 2022).




by AgentX86 - 2022-06-12 20:55:13

Welcome to the group (unfortunately).

I don't have an ICD and there are some differences.  VT is a very serious condition and your EP is going to want to be careful. But on to the questions.

1) No, but there is no reason not to.  I had an AV ablation and pacemaker implant litterally simultaneously.  One EP working at one end and another at the other. Once they have you in there and prepped, it would be easier to do the whole job.

2) The ICD won't hold you back.  Your EP may want you to take it easy to make sure you don't have any VT episodes.  The ICD firing could ruin your day.  It would probably be best to creep up on your desired activity.  Your EP may limit your heart rate for at least a while anyway, to see how you respond.

3) Backpacking won't be an issue but, yes, you'd probably be better off with a sub-pec impant.  It is harder to do but that's what the doctors get paid for.  Recovery will likely be a little harder too but TANSTAAFL.

A sub-q placement may interfere with the pack straps.  This is manageable but why do it if it isn't necessary. I'm not sure what your concern with the lump is but if it's because of backpacking, sure.

4) Sure, it's somewhat harder to do and some EPs may subcontract that job to another doctor but it's your body and your money(depending on where you live - pease fill out your bio). Who cares if the doctor misses his tee time?

5a) The collar bone hardware won't matter but if it does, they'll just take it out.  After the fracture heals, the hardware doesn't do anything.  I just had the hardware taken out of my wrist after only a few months.

5b) How long is a piece of string?  A defib pulse takes a lot of juice so ICD batteries are larger than most pacemaker batteries.  The more defib jolts delivered, the faster the battery depletes.  If it never fires, the extra charge can extend the life past that of a pacemaker. If it fires regularly, not so much.  It may last three, or ten, years.

BTW, since you're a cyclist, you might want to read the threads here concerning pacemakers and cycling.  Some models/manufacturers are better than others.  It likely won't matter to you, in your situation, but it's probably worth the ask.

Take it easy.  I'm sure you'll do fine.  Again, welcome to the club.

Thank you… in some uncertain times (for me)

by Rashoop - 2022-06-12 22:43:48


Thank you for taking the time to reply. Your candid nature is appreciated. This has all been a bit to take in, and I cannot tell all of you how much it means to find a resource like this. My docs have been great (will fill out my bio... I'm "lucky" to be in Orange County, California, so throwing a rock in any direction should hit a decent doc ;-), but they're busy, and Covid doesn't help.

Bottom line is that a simple "ICD implant + backpacking" Google search landed me here. Lots of questions, and I think... I know, I'm in the right place. Pardon my "French", but when you go in for what you think is a routine check, and find out the reality...holy sh@t. All of this is as fresh as bread out of the oven to me. Just trying to figure out the seismic shift.

Again, thank you for your reply. I feel I have a place here to learn. Without knowledge, where are we?

Some more info

by Rashoop - 2022-06-12 23:05:33

Should have added that the question about a sub-pectoral implant was in response to other reading I've done here saying that carrying a heavier pack is less of an issue if the ICD is buried a bit more. That's the "intriguing" part. I'm going more ultra-light, but I do still like some creature comforts! I'll check if my doc is comfortable doing that. 

Sub pec

by PacedNRunning - 2022-06-13 05:57:25

Hi. Actually under the skin is preferred if your athletic. Mine is and I have no issues. What you could ask is for your pacemaker to be placed more towards the center of your chest vs close to the arm. Not directly in the middle but closer to the middle. Mine is super low on my chest so it doesn't bother me for sports etc. Under the muscle makes future replacements more challenging with possible damaging the leads due to the angle under the muscle. I know of a lady who backpacks and requested to have hers placed more towards the middle and it's been great for her. You could also inquire about S-ICD's. Those go under the armpit and no leads in the heart. 

Great info... thank you

by Rashoop - 2022-06-13 12:14:18

Hello PacedNRunning,

Thank you for your reply. I'm now waiting until my EP's office is open so I can inquire about specific placement, as well as the S-ICD. He's a great, caring doc, and I'm confident he'll do what he can to accommodate my passion for backpacking.

Also, just under the skin does seem to have some compelling benefits (shorter recovery, easier to get to in the future, etc.). Your experience is greatly appreciated.

Some Info

by Old male - 2022-06-13 21:48:59


When I was diagnosed with Vtac they wanted to implant the next day.  I waited 3 days to get through the weekend.  8 year ICD Patient. 1st one lasted 7 yrs before battery depletion.  Shocked twice and over before i realized what happened.  Was not really painful.  First time I felt myself passing out with zero warning....then ZAP...I didn't pass out.  Have read stories of those who fall down and become unconscious.  Doubt your doctor can tell how you will react.  I just live life work and play like nothing is wrong.  Remember it's main job is to stop cardiac arrest.  Haven't had any problem with exercise.  Just first month or two, don't raise your arm any higher than shoulder height.  This period is to allow leads time to attach to tissue and stabilize. The first month I wore a small strap that attached my wrist to waste area to prevent accidental movement during sleep.  Good luck and keep us posted of your progress. 

All the best!

by lildanishgirl - 2022-06-15 21:33:22

Hi Bob! Regarding battery life... I've had my ICD for about 3 years. When it was implanted, there was 10 years of battery life and 3 years later, there's still 10 years of battery life! I've only been shocked once. Since it basically just sits there, I guess it's not using up much battery! I'm not a backpacker like you, so it's hard to comment on those questions. I wish you all the best!

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You play MP3 files on your pacer.

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