THERAPEUTIC PROCEDURES << BACK ICD placement Most ventricular tachycardias are treated with an implantable cardioverter-defibrillator (ICD). An ICD is used in patients at risk for recurrent, sustained ventricular tachycardia or fibrillation. The ICD is a small device connected to leads positioned inside the heart or on its surface. The leads are used to deliver electrical shocks, monitor the cardiac rhythm and sometimes pace the heart to correct irregular rhythms. When an ICD detects ventricular tachycardia or fibrillation, it shocks the heart to restore the normal rhythm. An ICD may be implanted using a small incision under the collar bone. The surgeon places a lead into a vein and guides it into the heart chamber. A separate, small generator is placed under the skin in the upper chest and attached to the leads. Rarely, a surgeon may implant the ICD outside the heart, sewing the lead onto the heart muscle-a procedure that requires open heart surgery. Patients undergoing ICD surgery can expect to stay in the hospital from one to three days. After surgery, the ICD will be programmed and functions will be checked in Providence Heart Institute's electrophysiology lab, which is among the busiest in the Southeast.