Having an Implantable Cardioverter Defibrillator (ICD) implanted is a major decision—one that comes with life-saving benefits but also a set of potential risks. I know this firsthand. On March 28, 2022, after a terrifying episode of ventricular tachycardia, I was rushed into surgery and received my ICD. That moment changed everything.

If you’re considering an ICD or recently had one implanted, you may be wondering about the possible complications. That’s why I wrote this—from the real perspective of someone who’s been through it. Let’s explore the most common ICD implantation risks, how to manage them, and how you can live confidently with your device.

1. Surgical Risks: The Reality of ICD Implantation

Getting an ICD is considered a routine procedure for cardiac specialists, but like all surgeries, it carries risks.

Infection is one of the most frequent concerns. Redness, swelling, or discharge around the implant site are warning signs. Left untreated, infection could lead to device removal.

Other possible risks include:

• Bleeding at the surgical site

• Blood clots near the leads

• Anesthesia-related issues

Before my surgery, I remember lying in the hospital bed, nervous about what was coming. I followed every post-op care instruction carefully, but I was still hyper-aware of every small sensation.

How to manage this risk:

• Keep the incision area clean

• Avoid heavy lifting and upper-body strain during early recovery

• Call your doctor if you notice signs of infection, fever, or new pain

Learn more about preparing for ICD surgery →

2. Lead Displacement: Why Movement Matters Early On

ICDs are connected to your heart by thin wires called leads. These leads need to stay firmly in place to monitor and respond to abnormal rhythms. If they shift—a complication called lead displacement—the ICD may not work properly.

I remember being afraid to move in the early days. I worried that something as simple as reaching for the remote could pull a lead out of position. That anxiety wasn’t unfounded; lead displacement is one of the more common post-op issues.

Common symptoms include:

• Chest pain

• Unexpected shocks

• Lightheadedness or fainting

Prevention tips:

• Avoid overhead arm movement for several weeks

• Follow all post-op restrictions closely

• Keep your follow-up imaging appointments

3. Device Malfunction: A Rare but Important Risk

Modern ICDs are extremely reliable, but no technology is perfect. Malfunctions can happen—whether from manufacturing defects, battery failures, or software errors.

I remember feeling anxious about this in the first few months. Every unusual heartbeat made me wonder if the device would do its job when I needed it—or trigger unnecessarily when I didn’t.

Device malfunctions may cause:

• Shocks when they’re not needed

• Failure to respond to dangerous rhythms

• Early battery drainage

Risk management:

• Attend all follow-up appointments

• Enable remote monitoring with your care team

• Stay aware of recall announcements from your device manufacturer

For more details, read: Understanding Your ICD: Functions and Features

4. Inappropriate Shocks: When the Device Overreacts

An inappropriate shock is one of the most emotionally challenging ICD complications. It happens when your ICD mistakenly delivers a shock for a rhythm that isn’t life-threatening.

The idea of being shocked out of nowhere was hard to accept. It hasn’t happened to me yet, but I know many patients who’ve experienced it, and it deeply shook their confidence in the device.

Inappropriate shocks can be caused by:

• Atrial fibrillation or other irregular rhythms

• Poor lead placement or movement

• Electrical interference

How to reduce the chance:

• Work with your doctor to fine-tune device settings

• Report all shocks to your healthcare provider

• Use remote telemetry to identify problems early

5. The Mental and Emotional Toll of Living with an ICD

One of the most overlooked complications isn’t physical at all—it’s emotional. Living with a device that can deliver shocks at any moment can take a real psychological toll. I’ve had nights where I woke up in a panic, heart racing, imagining the device going off.

It’s common to experience:

• Anxiety

• Depression

• PTSD-like symptoms

This invisible weight can affect sleep, relationships, and even your willingness to be active.

What helped me:

• Cognitive-behavioral therapy (CBT)

• Meditation and breathwork

• Talking to others in ICD support groups

If you’re struggling with this side of recovery, you’re not alone—and support can make a big difference. Read: Supporting a Loved One with an ICD

6. ICD Battery Life and Replacement: A Long-Term Responsibility

ICDs run on batteries that typically last between five and ten years. While the replacement procedure is usually simpler than the initial surgery, it’s still a surgery—and it comes with some emotional weight.

You’ll need to track your battery status closely. Your care team will give you plenty of notice when it’s time for replacement, but it’s something that stays in the back of your mind.

Best practices:

• Schedule regular device checks

• Know your device’s average battery lifespan

• Discuss the replacement process well in advance

You can learn more in our guide: ICD Battery Life and Replacement: Key Facts

7. Blood Vessel or Heart Damage: A Rare but Serious Possibility

Though uncommon, one of the more severe ICD implantation risks involves damage to blood vessels or the heart muscle during lead placement. This could result in internal bleeding or cardiac tamponade—a buildup of fluid around the heart.

These complications are extremely rare when handled by experienced medical teams, but they can be life-threatening if they do occur.

To minimize the risk:

• Choose a surgeon with extensive ICD experience

• Follow all pre-op instructions

• Report any sharp or sudden chest pain after surgery immediately

8. Long-Term Maintenance: It’s Not Set-and-Forget

Many people think that once the ICD is in, they’re set for life. In truth, ICDs require ongoing care.

Maintenance includes:

• Remote device monitoring

• In-person device interrogations

• Occasional software updates or reprogramming

• Possible lead replacements over time

In my case, I’ve found this ongoing care both reassuring and a little exhausting. But regular monitoring helps catch problems early, which gives me peace of mind.

Key to success:

• Keep all follow-up appointments

• Ask questions if anything feels different

• Use a calendar or app to stay on track

9. Daily Life Adjustments: Navigating the Transition

The initial adjustment to living with an ICD can be more difficult than you might expect. Simple things—like lifting groceries, hugging someone tightly, or even sleeping on your side—can feel strange or uncomfortable at first.

In my first few weeks post-surgery, I was hesitant to travel, exercise, or attend concerts. But over time, I learned what my limits were—and how to safely push them.

Tips that helped me adjust:

• Start slow with activities

• Wear loose clothing around the implant site

• Give yourself permission to rest and adapt

To explore more lifestyle changes, see: Living with and Caring for an ICD: Essential Tips

10. Electrical Interference: Modern Myths and Real Precautions

A common concern among ICD patients is whether electronics or appliances might interfere with their device. In most cases, modern ICDs are highly resistant to interference.

You don’t need to avoid your phone, microwave, or electric toothbrush. However, certain medical environments and industrial equipment may pose risks.

Real precautions include:

• Always notify medical providers before MRI scans

• Avoid placing magnets near the ICD

• Keep smartphones and tablets six inches away from your chest

If your ICD is MRI-compatible, you’ll have more flexibility—but you’ll still need medical supervision for scans.

Frequently Asked Questions: ICD Risks and Recovery

Final Thoughts: ICD Risks Are Real, but So Is the Life You Can Reclaim

Getting an ICD was one of the most emotional experiences of my life. Yes, there were risks. Yes, there were complications to consider. But I’m still here—and because of this device, I get to see my daughter grow up, attend concerts, hike trails, and live fully.

If you’re preparing for ICD surgery or adjusting to life after implantation, know that you’re not alone. Complications can be scary, but with support, education, and the right mindset, you can manage them and move forward with confidence.

For deeper guidance, read my book: Understanding ICD Implants: A Comprehensive Guide