Health Encyclopedia - Discharge Instructions
Implantable cardioverter defibrillator - discharge
ICD - discharge; Defibrillation - discharge
When You Were in the Hospital
A type of heart specialist called an electrophysiologist or a surgeon made a small incision (cut) in your chest wall. A device called an implantable cardioverter-defibrillator (ICD) was inserted under your skin and muscle. The ICD is the size of a large cookie. Leads, or electrodes, were placed in your heart and were connected to your ICD.
The ICD can quickly detect life-threatening abnormal heartbeats (arrhythmias). It is designed to convert any abnormal heart rhythm back to normal by sending an electrical shock to your heart. This action is called defibrillation. This device can also work as a pacemaker.
What to Expect at Home
When you leave the hospital, you will be given a card to keep in your wallet. This card lists the details of your ICD and has contact information for emergencies.
Carry your ICD identification card with you AT ALL TIMES. The information it contains will tell all health care providers you see what type of ICD you have. Not all ICDs are the same. You should know what type of ICD you have and which company made it. This can let other doctors check the device to see if it works right.
You should be able to do most of your normal activities within 3 - 4 days after surgery. But you will have some limits for up to 4 - 6 weeks.
Do not do these things for 2 - 3 weeks:
- Lift anything heavier than 10 - 15 pounds
- Push, pull, or twist too much
- Wear clothes that rub on the wound
Keep your incision completely dry for 4 - 5 days. After that, you may take a shower and pat it dry. Always wash your hands before touching the wound.
For 4 - 6 weeks, do not lift your arm higher than your shoulder on the side of your body where your ICD was placed.
You will need to see your health care provider regularly for monitoring. Your doctor will make sure your ICD is working correctly and will check to see how many shocks it has sent and how much power is left in the battery. Your first follow-up visit will probably be about 1 month after your ICD is placed.
ICD batteries are designed to last 4 - 8 years. Regular checks of the battery are needed to see how much power it has left. You will need minor surgery to replace your ICD when the battery begins to run down.
Be Careful Around Things with Magnets
Most devices will not interfere with your defibrillator, but some with strong magnetic fields might. Ask your provider if you have questions about any specific device.
Most appliances in your home are safe to be around. This includes your refrigerator, washer, dryer, toaster, blender, personal computer and fax machine, hair dryer, stove, CD player, remote controls, and microwave.
There are several devices you should keep at least 12 inches away from the site where your ICD is placed under your skin. These include:
- Battery-powered cordless tools (such as screwdrivers and drills)
- Plug-in power tools (such as drills and table saws)
- Electric lawnmowers and leaf blowers
- Slot machines
- Stereo speakers
Tell all health care providers that you have an ICD. Some medical equipment may harm your ICD. Because MRI machines have powerful magnets, talk to your doctor before having an MRI.
Stay away from large motors, generators, and equipment. Do not lean over the open hood of a running car. Also stay away from:
- Radio transmitters and high-voltage power lines
- Products that use magnetic therapy, such as some mattresses, pillows, and massagers
- Electrical or gasoline-powered appliances
If you have a cell phone:
- Do not put it in a pocket on the same side of your body as your ICD.
- When using your cell phone, hold it to your ear on the opposite side of your body.
Be careful around metal detectors and security wands.
- Handheld security wands may interfere with your ICD. Show your wallet card and ask to be hand searched.
- Most security gates at airports and stores are okay. But do not stand near these devices for long periods. Your ICD may set off alarms.
When to Call the Doctor
Tell your health care provider about every shock you feel from your ICD. The settings of your ICD may need to be adjusted, or your medicines may need to be changed.
Also call if:
- Your wound looks infected. Signs of infection are redness, increased drainage, swelling, and pain.
- You are having the symptoms you had before your ICD was implanted.
- You are dizzy, have chest pain, or are short of breath.
- You have hiccups that do not go away.
- You were unconscious for a moment.
- Your ICD has sent a shock and you still do not feel well or you pass out. Talk to your provider about when to call the office or 911.
Baddour LM, Epstein AE, Erickson CC, Knight BP, Levison ME, Lockhart PB, Masoudi FA, Okum EJ, Wilson WR, Beerman LB, Bolger AF, Estes NA 3rd, Gewitz M, Newburger JW, Schron EB, Taubert KA; American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee; Council on Cardiovascular Disease in Young; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Nursing; Council on Clinical Cardiology; Interdisciplinary Council on Quality of Care; American Heart Association. Update on cardiovascular implantable electronic device infections and their management: a scientific statement from the American Heart Association. Circulation. 2010;121:458-477.
Swerdlow CD, Hayes DL, Zipes DP. Pacemakers and cardioverter-defibrillators. In: Mann DL, Zipes DP, Libby P, et al, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 36.
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.