ICD (Implantable Cardioverter-Defibrillator) Placement: What to Expect at Home

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.

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 may be able to see and feel the outline of the ICD under your skin.

You may 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.

You'll need to take steps to safely use electric devices. Some of these devices can stop your ICD from working right for a short time. Check with your doctor about what to avoid and what to keep a short distance away from your ICD. For example, you will need to stay away from things with strong magnetic and electrical fields. An example is an MRI machine (unless your ICD is safe for an MRI). You can use a cell phone and other wireless devices, but keep them at least 6 inches away from your ICD. Many household and office electronics don't affect an ICD.

• 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.
• Do not raise your arm (on the side of your body where the ICD is located) above shoulder level until your doctor says it's okay. This helps keep the ICD and leads in place while you heal. Your doctor may recommend gentle range-of-motion exercises for your shoulder.
• For at least 3 or 4 weeks, or for as long as your doctor says:
  • 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.
  • 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 may need to take about 1 to 2 weeks off from work. It depends on the type of work you do and how you feel.
• 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).

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Read and follow all instructions on the label.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
  • Do not take aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), or other nonsteroidal anti-inflammatory drugs (NSAIDs) unless your doctor says it is okay.

• Keep the area clean and dry.
• Ask your doctor when you can shower or take a bath.
• 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. They can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing.

• Ask your doctor what sort of activity and intensity is safe for you.

• Ask your doctor for a list of electric devices that you might need to keep a short distance from your ICD.
• Be sure you have an action plan from your doctor about what to do if you get shocked.
• 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.
• Tell all of your doctors, dentists, and other health professionals that you have an ICD before you have any test, procedure, or surgery.
• Be sure you know what to do if you hear an alarm or feel a vibration from your ICD. Your doctor can give you instructions.
• Have your ICD checked as often as your doctor recommends. In some cases, this may be done from your home. Your doctor will give you instructions about how to do this.
• Talk with your doctor about the possibility of turning off the ICD at the end of life. You can put your wishes about the ICD in an advance directive.