Implantable Cardioverter-Defibrillator Placement: What to Expect at Home
Implantable cardioverter-defibrillator (ICD) placement is surgery to put an ICD in your chest. An ICD is a small, battery-powered device that fixes life-threatening changes in your heartbeat. If your heart starts to beat too fast, the ICD sends a shock to your heart to restore a normal heartbeat. Many ICDs also act as pacemakers, sending weaker shocks that speed up the heart if the heartbeat gets too slow.
Your chest may be sore where the doctor made the cut (incision) and put in the ICD. You also may have a bruise and mild swelling. These symptoms usually get better in 1 to 2 weeks. You may feel a hard ridge along the incision. This usually gets softer in the months after surgery. You probably will be able to see and feel the outline of the ICD under your skin.
You will probably be able to go back to work or your usual routine 1 to 2 weeks after surgery. Your doctor will talk to you about how often you will need to have the ICD checked.
When you have an ICD, it is important to avoid electrical devices that can stop your ICD from working right. Check with your doctor about what you need to stay away from, what you need to use with care, and what is okay to use. You will need to stay away from things with strong magnetic and electrical fields such as MRI machines, welding equipment, and power generators. You can use a cell phone, but keep it at least 6 inches away from your ICD. You can safely use most household and office electronics such as kitchen appliances, electric power tools, and computers.
This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.
How can you care for yourself at home?
- Rest when you feel tired. Getting enough sleep will help you recover.
- Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
- For 4 to 6 weeks:
- Avoid activities that strain your chest or upper arm muscles. This includes pushing a lawn mower or vacuum, mopping floors, swimming, or swinging a golf club or tennis racquet.
- Do not raise your arm above shoulder level.
- Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or heavy aerobic exercise.
- Avoid lifting anything that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a child.
- Ask your doctor when you can drive again.
- You will probably need to take about 1 to 2 weeks off from work. It depends on the type of work you do and how you feel.
- You may shower as usual. Pat the incision dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
- Ask your doctor when it is okay for you to have sex.
- You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
- Drink plenty of fluids (unless your doctor tells you not to).
- Take pain medicines exactly as directed.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
- Do not take aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), or other nonsteroidal anti-inflammatory drugs (NSAIDs) unless your doctor says it is okay.
- If you think your pain medicine is making you sick to your stomach:
- Take your medicine after meals (unless your doctor has told you not to).
- Ask your doctor for a different pain medicine.
- If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
- If you have strips of tape on the incision, leave the tape on for a week or until it falls off.
- Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
- Keep the area clean and dry.
- Check with your doctor before you start an exercise program. Your doctor may recommend that you work with a physical therapist to learn how to exercise safely with an ICD.
- Carry your ICD identification card with you at all times. The card should include the ICD manufacturer and model information.
- Wear medical alert jewelry that states you have an ICD. You can buy this at most drugstores.
- Have your ICD checked as often as your doctor recommends.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.
When should you call for help?
Call 911 anytime you think you may need emergency care. For example, call if:
- You passed out (lost consciousness).
- You have severe trouble breathing.
- You have sudden chest pain and shortness of breath, or you cough up blood.
- You receive more than 1 shock from your ICD.
- You have symptoms of a heart attack, such as:
- Chest pain or pressure.
- Shortness of breath.
- Nausea or vomiting.
- Pain that spreads from the chest to the neck, jaw, or one or both shoulders or arms.
- Dizziness or lightheadedness.
- A fast or uneven pulse.
After calling 911, chew 1 adult-strength aspirin. Wait for an ambulance. Do not try to drive yourself.
Call your doctor now or seek immediate medical care if:
- You receive 1 shock from your ICD.
- Your heartbeat feels very fast or slow, skips beats, or flutters.
- You are dizzy or lightheaded, or you feel like you may faint.
- You have new or increased shortness of breath.
- You have pain that does not get better after you take pain medicine.
- You have loose stitches, or your incision comes open.
- Bright red blood has soaked through the bandage over your incision.
- You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- Swollen lymph nodes in your neck, armpits, or groin.
- A fever.
- You have signs of a blood clot, such as:
- Pain in your calf, back of the knee, thigh, or groin.
- Redness and swelling in your leg or groin.
Watch closely for changes in your health, and be sure to contact your doctor if:
- You have any problems with your ICD.