The ICD is usually implanted using the endocardial (transvenous) approach. During the procedure, a local anesthetic is injected to numb the area.
Small incisions are made in the chest where the lead(s) and device are inserted. The lead is inserted through the incision and into a vein, then guided to the heart with the aid of the fluoroscopy machine. The tip of the lead is attached to the heart muscle, while the other end is attached to the pulse generator. The generator is placed in a pocket created under the skin in the upper chest.
When the endocardial approach is used, the hospital recovery time is generally 24 hours.