In some cases an electrophysiogist can provide an actual cure for a rhythm disturbance, sometimes by performing an ablation. It treats the problem, then, each time it occurs. Many doctors use an ICD in combination with rhythm control medications called antiarrhythmics. No, it isn't. In the near future, ICDs will be available which can be used for patients with these other rhythm problems.
Doctors can very often provide good heart rhythm control for patients with medication alone.
If an ICD is one of those solutions, the doctor will know and discuss it with the patient. We always hear from them that shocks are startling, jolting, unsettling, and it's easy to understand why. To begin with, the ICD delivers a shock to prevent a dangerously fast heart rhythm from hurting a patient. That rhythm, then, must be present for the device to recognize before it does anything. Naturally, this is startling.