A decision aid for patients considering ICD therapy for primary prevention.


This site is for patients with heart failure considering an ICD who are at risk for sudden cardiac death (primary prevention). This website will lead you step-by-step through some information on ICDs that may be helpful. We also hope this will make talking to your doctor easier.

What is an Implantable Cardioverter Defibrillator (ICD)?

An ICD is a small device that is placed under the skin of the chest. Wires (called “leads”) connect the ICD to the heart. An ICD is designed to prevent an at-risk person from dying suddenly from a dangerous heart rhythm. When it senses a dangerous heart rhythm, an ICD gives the heart an electrical shock. It does this in order to get the heart to beat normally.

Is an ICD right for me?

The ICD does not stop an advancing illness like heart failure. The only purpose of the ICD is to try to get a dangerous heart rhythm to beat normally.

While the future is always unpredictable, there is an important trade-off to consider when deciding whether to get an ICD.

Consider two possible paths:

Path 1

You may choose to get an ICD. You may be feeling like you usually do, then a dangerous heart rhythm could happen. The ICD may help you live longer by treating a dangerous heart rhythm. You will continue to live with heart failure that may get worse over time.

“I’m not ready to die. I have so much I’m trying to stay alive for. Even if it means getting shocked, I’m willing to do anything that can help me live longer.”

Path 2

You may choose to not get an ICD. You may be feeling like you usually do and then a dangerous heart rhythm could happen.  You may die quickly from the dangerous heart rhythm.  Some people are okay with this.

“I’ve lived a good life. The idea of dying quickly sounds like a painless way to go. I’ve always said I hope to die in my sleep. Going through surgery and getting shocked is not the kind of thing I want.”

VIDEO: Consider the two possible paths.

Fred Masoudi, MD
Heart Doctor

VIDEO: Is an ICD the right choice for you?

Paul Varosy, MD
Electrophysiologist

Frequently Asked Questions

Due to your heart failure, you are at higher risk for developing a dangerous heart rhythm.  A dangerous heart rhythm can cause you to die within minutes if not treated.

Heart failure is when a heart is too weak to pump enough blood for the body. People with heart failure sometimes have breathing problems, leg swelling, and feel tired. Some people with heart failure may have no symptoms.

It is best not to remove the ICD unless you have an infection or are having the ICD replaced.

Yes. The ICD is put under the skin and one or more wires (called “leads”) are put into the heart. The surgery takes a few hours. You may stay in the hospital overnight.

Yes, it is possible to turn off the ICD without surgery. This is even recommended when a person is close to dying of another cause.

In the future, people may reach a point where living as long as possible is not what they want anymore. This could be because of worsening heart failure or another illness. When this happens the ICD can be turned off to avoid shocks.