Discharge Instructions for Implantable Cardioverter-Defibrillator (ICD)

You had a procedure to insert an implantable cardioverter-defibrillator (ICD). Once inside your body, an ICD monitors your heart rhythm (the speed and pattern of your heartbeat). If your rhythm becomes too fast, it can be deadly. The ICD helps to correct a too-fast rhythm by sending out an electrical shock. Most ICDs can also treat a heartbeat that is too slow by monitoring your heart rate and sending out electrical signals as needed. As you recover, follow the instructions below. Also follow any other directions you’re given by your healthcare provider.

Activity

• Don’t drive until your healthcare provider says it’s OK. It's recommended that you not drive for as long as your healthcare provider advises after the first implant and again if the device fires. The life-threatening heart rhythms these devices treat can cause you to lose consciousness, which would be very dangerous if you are driving.

• Limit your activity as instructed.

• Ask your healthcare provider if you have any limits on bathing.

• If you are fitted with an arm sling, keep your arm in the sling for as long as your healthcare provider tells you to. But make sure that your arm is not completely immobilized for more than a week. This can lead to a stiff shoulder.

• Don't raise your arm on the incision side above shoulder level or stretch the arm behind your back for as long as your healthcare provider advises. This gives the device lead wires time to attach securely inside your heart.

• Ask your healthcare provider when you can expect to return to work and if you will have any limits in your work duties for any period of time. If you have a job that requires a commercial driver's license, you must be aware that having an ICD implanted is a restriction for this type of license.

Other precautions

• For 7 days after implantation of your device, take your temperature and check your incision each day for signs of infection. These signs include redness, swelling, drainage, or warmth.

• Take your medicines exactly as directed. Don’t skip doses or stop medicines without first discussing this with your healthcare provider. Tell your healthcare provider if you are having any new symptoms that might be a side effect.

• Carry an ID card that contains information about your ICD. You should have been given a temporary ID card with information about your ICD on it. You will get a permanent card mailed to you. Carry this card with you. You can show this card if your ICD sets off a metal detector. You should also show it so you won't be screened with a hand-held security wand.

• Before you have any treatment, tell all healthcare providers and your dentist that you have an ICD.

• Be careful when using cell phones and other electronic devices. Keep them at least 6 inches away from your ICD. It's safest to hold all cell phones to the ear farther from your ICD or use the speaker mode setting. Don’t carry your phone or electronic device in your chest pocket, over the ICD. Experts advise carrying your cell phone and other electronics in a pocket or bag below your waist. Most cell phones and electronic devices don't interfere with ICDs. But some cell phones and electronic devices such as smartwatches use powerful magnets for wireless charging. These may interfere with the normal function of your ICD. The magnet used for charging or other magnet accessories can also interfere with the normal function of your ICD. These devices should be kept away from your ICD when wirelessly charging or stored. Follow any other instructions given to you by your healthcare provider or from the manufacturer of your ICD.

• Stay away from strong magnets. Examples are those used in MRIs or in handheld security wands. Ask your healthcare provider if your ICD is MRI-compatible. Most modern-day ICDs are MRI-compatible.

• Stay away from strong electrical fields. Examples are those made by radio transmitting towers, “ham” radios, and heavy-duty electrical equipment.

• Don't lean over the open hood of a running car. A running engine creates an electrical field. Other than your car, most items around the house, such as your microwave, are perfectly safe. Most common yard work equipment, such as your lawn mower, is safe. If you use commercial-grade tools, such as an arc welder, check with your healthcare provider for advice.

• Make regular appointments with your healthcare provider. They will check the device to make sure it continues to work correctly.

Follow-up care

Follow up with your healthcare provider as advised.

Ask your healthcare provider about remote monitoring of your ICD. Your ICD may have a remote monitoring system that can send information over the phone or Internet to your healthcare provider.

If you are not able to have your device monitored remotely, you will have periodic checkups in your cardiologist's office to check the function and battery life of your ICD. On average, plan to have your device checked every 6 months, or as directed by your healthcare provider. The generator battery can last as long as 10–12 years.

When to call your healthcare provider

Call your healthcare provider right away if you have any of these:

• A “shock” sensation from your ICD. This may feel like being kicked in the chest.

• Fever above 100.4°F (38°C), or as directed by your healthcare provider

• Signs of infection at your incision site. These include redness, swelling, drainage, or warmth.

• Twitching in your chest or abdominal muscles

• Increased pain around your ICD

• Bleeding at the incision site

• Arm swelling on the side of the incision

• Uncontrolled hiccups

Call 911

Call 911 right away if any of these occur:

• You get more than one shock

• You lose consciousness with the shock

• You have other severe symptoms such as chest pain before or after the shock