What is a defibrillator?

A defibrillator implant is a small device surgically implanted in the chest to maintain the heart’s electric rhythm. The surgery is very common: over 130,000 Americans receive a defibrillator implant every year.

If you or a loved one requires a defibrillator implant, you’ll undoubtedly have many questions—questions that can’t always be adequately explained in a forty-five minute doctor’s appointment. Clinical cardiac electrophysiology specialist Jeffrey L. Williams, MD, MS, FACC, FHRS, provides a complete, easy-to-understand guide to defibrillator implantation.

The author of What Is a Pacemaker?, Dr. Williams begins with an explanation of how defibrillators work and the conditions they treat. Williams then discusses how doctors determine whether patients are good candidates for defibrillators and provides an overview of the implantation process. Potential complications both before and after defibrillator implantation are discussed, as is surgical recovery and follow-up treatment. For readers having difficulty with medical terminology, Dr. Williams offers a helpful glossary at the back of the book.

Patients, caregivers, and family members alike will benefit from Dr. Williams’s straightforward explanations. If you’re a candidate for defibrillator implantation, this book can help you approach surgery with a full understanding of the procedure and what it means to your quality of life.

Dr. Williams gives all his defibrillator patients copies of What is a Defibrillator? but it is available for purchase at Amazon.

Contents include:

1. Basics of the Heart Anatomy and Conduction System

Blood flow through the heart

Electrical conduction system of the heart

Coronary arteries

Electrocardiogram (ECG or EKG)

2. Basics of Heart Failure and Sudden Death

What is congestive heart failure?

What causes heart failure?

Know your ejection fraction!

What is ventricular fibrillation or ventricular tachycardia?

Is there a difference between atrial fibrillation and ventricular fibrillation?

3. Reasons for Defibrillator Implantation


Survival benefits of defibrillators

Disease states at risk for sudden cardiac death (Writing Committee 2008) Miscellaneous reasons for defibrillator implantation

Before you get a defibrillator implantation


4. What are Defibrillators and How Do They Work?

Location of a transvenous defibrillator implantation

Location of a subcutaneous defibrillator implantation

What are the elements of a defibrillator?

Defibrillator to help treat heart-failure patients

How are defibrillators programmed?

How does a defibrillator stop a life-threatening arrhythmia?

Are defibrillator shocks painful?

When should I have the pacing features of my defibrillator turned on?

Miscellaneous reasons for pacing support of defibrillator patients

5. Preoperative Workup and Evaluation (Meeting the Implanting Physician)


History of present illness (HPI)

Past medical and surgical history (PMH)

Social history


Family history

Physical exam (including vital signs)

Pertinent studies

Preoperative risk assessment


Use of contrast agents during defibrillator implantation

Thyroid issues

6. The Implant Procedure

Registration and check-in

Informed-consent process

The procedure room

The implant procedure

What happens if my doctor could not successfully place a left-ventricular lead?

Immediately post implant

Day after the implantation

What is defibrillator-threshold testing (DFT)?

7. Possible Complications of Device Implantation


Complications that can occur prior to going home

Complications that usually occur within thirty days of implant

Complications that usually occur more than one month after implant

8. Postoperative Care (The First Month)

Care of the incision (showering/bathing)

Activity limitations


The first follow-up appointment after the defibrillator implantation

Lifestyle considerations

Can handheld electronics interfere with your defibrillator?

9. Long-Term Care and Follow-Up


Defibrillator function

Patient monitoring features of defibrillators

Incision care

Battery/Lead life


Can a defibrillator worsen heart failure?

What should I do if the defibrillator shocks me (or my loved one)?

Long-term psychosocial effects of defibrillators

Do defibrillators keep extremely elderly patients alive and prevent natural death?

10. Psychosocial Impact of Defibrillators

Adjustment to life after defibrillator implantation

Quality of life in defibrillator patients

How does defibrillator implantation affect your life partner?

How do defibrillator shocks affect the patient?

What are phantom shocks?

Why is a shock plan important?

Defibrillators in children and young adults

Long-term acceptance of the defibrillator

11. What are Device Recalls/Advisories/Alerts?

12. Conclusion