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Instructions following an ICD implantation

Thank you for trusting us with your heart!

Care of Your Implant Site

To ensure proper healing, do not lift the affected arm’s elbow above the level of your shoulder for 2 months. Do not lift or push more than 10 pounds for 2 months. Do not drive for 72 hours. Leave the dressing in place and we will remove it at your followup appointment. The initial dressing is waterproof, so you may shower with this on. After the dressing is removed, you may shower, but try to keep the site dry for 1 week. Try not to pick at the glue on your skin. Do not submerge or swim until a scar is formed. Once the leads are completely healed (about 2 months), you can resume any vigorous activity that your doctor allows. If you are discharged with a prescription for an antibiotic, be sure to take these until the supply is gone.

If you passed out, do not drive until cleared by physician.

Post-operative Appointments

You will have an appointment a few days after implantation of the ICD to inspect the surgical incision to make sure it is well healed. Again, be sure to call if there are any concerns about the appearance of the surgical site.

You will have a second appointment 2-3 months after the implantation. This appointment is crucial because a check will be done to ensure the ICD is functioning properly. The ICD will be reprogrammed to maximize the life of the battery.

Replacing the Battery

The battery generally lasts 7 to 10 years, depending on many factors including how often it paces the heart, how often it has to shock a dangerous rhythm problem, and how much energy it uses when pacing. The device alerts the physician when it needs replacement by changing the rate at which it paces. This is recognized by the telephone monitoring service or during a routine office visit. A new battery can be inserted as an outpatient procedure. It is performed under local anesthesia in less than one hour.

Usually, only the pulse generator (battery) needs to be replaced. Rarely though, a problem is discovered with one of the pacing wires. If this is the case, the wire is replaced and you will again have an arm restriction.

Long-term Use of Your ICD

Special Work Conditions: Most things you handle or work around on a daily basis are not going to influence your ICD system. However, your ICD is sensitive to strong electrical or magnetic fields. Your ICD may make a sound if you are too close to a magnet with a beep or tone, move away from the object immediately and call your doctor. Keep the following things 12 inches away from your ICD: strong magnets, magnetic wands used in airports, industrial equipment, generators and arc welders (>160 Amp). Also avoid standing near large electrical motors while they are running. Avoid remaining near anti-theft devices in doorways of buildings; walk through them at a normal pace. Have airport security hand search you.

Shooting a Gun: Shooting a gun is fine after the device in in place. When shooting a rifle, care should be taken to avoid placing the butt of the gun over the device itself, and shooting with the opposite arm is recommended.

Airport Metal Detectors: Have airport security hand search you. The ICD should not be effected by the security detection systems, but it is better to be hand searched.

Cellular Phones: It is unlikely that a cellular phone will interfere with the ICD.

Radiation Therapy: Should you ever require radiation therapy for any reason, care must be taken to avoid irradiating the ICD.

Surgery: Finally, should you require surgery in the future, some electrosurgical devices can interfere with ICD function. You should discuss this with your surgeon prior to any operation and let your cardiologist know about your surgical plans.

If You Feel A Shock

"The first one's free"

If you receive a shock, this means your ICD is working: this is what it is supposed to do. After the ICD shock, call your cardiologist. If the shock occurs at night, you can wait until morning to call unless you have consecutive shocks, or unless you feel badly after the shock. We will most likely ask you to send us a remote transmission when you call.

If The ICD Gives You 2 or More Consecutive Shocks, Seek Immediate Medical Attention

Remain calm and have someone be prepared to call an ambulance should you become unconscious.

Since you have an ICD, your family should learn CPR (CardioPulmonary Resuscitation). You can call your local first aid station or The American Heart Association to enroll in classes.

If you have any questions, please call the clinic at (903) 838-5500 or you can reach me directly at (501) 326-2173.

Thank you for letting us be a part of your care.

Kevin R. Hayes MD

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