Making a Decision – ICD or No ICD?

Your health care team has recommended an ICD because you have a heart condition that makes a dangerous heart rhythm more likely. This type of heart rhythm can cause the heart to suddenly stop beating (called sudden cardiac arrest). An ICD can help correct the abnormal rhythm and lower your chance of dying.

How? If and when the ICD senses this dangerous heart rhythm, it responds by giving the heart an electrical shock. This resets the heart to beat normally again.

It’s important to remember that the decision to get an ICD – or not – is yours to make. And it is very personal. What matters to you might be very different from someone else. Either choice – deciding to get an ICD or not – is reasonable.

For example:

The first step in making a decision is to remember that you have a choice – to get an ICD or not. Both are OK. Be sure to ask questions and gather the information you need.

Important steps in the process

To make a decision that is right for you, it’s important that you:

• Know that there is a decision to be made. In this case, the option is either to 1) get an ICD placed or 2) not get an ICD placed. Both choices are reasonable based on what’s important to you.
• Understand the pros and cons of having an ICD or not having one. It’s important to know the benefits and potential harms of having an ICD. If you are considering one, use one of our decision aids to help
• Think through your own values, what you want and the tradeoffs
  • Do you want to prevent sudden death or not?
    • Some patients might be older, sicker and have lots going on and may choose to have a less invasive course. This choice may mean they don’t have the protection of the ICD, so they may not live as long. For them, that might be OK.
    • Other people might think, I am feeling pretty good and have many years ahead of me, so I don’t mind getting shocked. That’s also OK.
  • Would you be OK with having a permanently implanted device and knowing that it could shock you to prevent sudden cardiac death?
• Get the information you need to make an informed decision that you feel good about. So next steps might be to ask your health care team more questions, do some more research, or talk with someone who has an ICD for a similar reason.