Implantable Cardioverter Defibrillator

WHAT YOU SHOULD KNOW:

• An implantable cardioverter (CAR-d-o-ver-ter) defibrillator (d-FIB-ri-la-ter) is also called an ICD. It is a device that monitors your heart rate and rhythm. The ICD gives your heart a shock if you start having arrhythmias (uh-RITH-me-uhs). Arrhythmias are when your heart does not beat normally. Some arrhythmias can cause the heart to stop beating. The ICD will shock your heart so that it starts beating normally again. An ICD can make your heart beat faster if it is not beating fast enough. It can also slow your heart down if it is beating too fast.
  
  
• An ICD is made up of a generator, a programmer, and leads. The generator and the leads will be placed inside you during surgery. The generator has a metal shell with a battery and a small computer inside. The computer monitors your heart rate and rhythm. Leads are wires that have one end that attach to the inside of your heart and the other end is connected to the generator. The generator transmits information about your heart to the programmer. Surgery is needed to get an ICD. The surgery may be done when you are already a patient in the hospital or you may come into the hospital the morning of your surgery. It is possible that you may go home after the surgery.
  
  
• The leads are usually placed inside the heart. There are some instances that the leads may be placed on the outside of the heart. The generator is usually placed in a pocket under the skin in the shoulder area. It may also be placed in a pocket under the skin in the abdomen (belly).

AFTER YOU LEAVE:

Medicines:

• Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicine. Do not use any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver. If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.

Activity Guidelines:

• Ask your caregiver if you need to avoid moving your shoulder or arm, and for how long.
  
  
• Ask your caregiver if you should avoid lifting heavy objects.
  
  
• Do not play any contact sports such as football or wrestling until your caregiver tells you it is okay.
  
  
• Do not rub the ICD area until your caregiver tells you it is okay.
  
  
• Do not wear tight clothing over the ICD until your caregiver says it is okay.
  
  
• Ask your caregiver when you can return to work.
  
  
• Your driving may be restricted. You may only be able to drive for a certain amount of time per day, or during certain hours.
  
  
• Do not shower or bathe until your caregiver says it is okay. Do not put any lotion or powder on the incision area.

What special things should I do once I have my ICD?

• Carry the ID card that your caregiver has given you. This card has important information about your ICD. Keep emergency phone numbers within easy reach.
  
  
• Stay away from magnets. This includes a MRI test (a MRI uses powerful magnets). It is safe to use household appliances such as microwaves, toasters, hair dryers, and computers.
  
  
• Tell airport security about your ICD. Ask to be searched by hand when in an airport or anywhere you must go through a security gate. The security gate or hand held wand could harm your ICD.
  
  
• Avoid leaning into a car engine or doing welding. You may need to change your job if you do these things.
  
  
• Keep an ICD diary. Record when you get a shock and what you were doing before you got the shock. Keep track of how you felt before and after the shock, as well as how many shocks you received. Write down the day and time of each shock. When you see your caregiver, be sure to bring your ICD diary with you. Other caregivers may also want to see your ICD diary. The information you have in your diary will help your caregivers treat you.
  
  
• Wear an ID bracelet to let other people know that you have an ICD. For more information, contact:
  • Medicalert Foundation
    2323 COLORADO AVENUE
    TURLOCK, CA 95382
    Phone: 1-209-6683333
    Phone: 1-888-633-4298
    

When is my next medical appointment?

• Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.
  
  
• You will need to see your caregiver two to four times a year for the rest of your life. You will also see an electrophysiologist (e-lek-tro-fizz-e-ALL-uh-jist). This is a caregiver specially trained to work with your ICD. Your caregivers will be able to tell how many arrhythmias you have had. They can also tell how many times the ICD has shocked your heart. Be sure to call your caregiver if you have any questions or concerns about your ICD.

What should I do if I get a shock from my ICD? The first time you feel a shock, it may scare you. It is important to sit or lie down and stay calm. Have someone stay with you if possible. If you feel fine afterwards, notify your caregiver during normal business hours that you received a shock.

Wellness hints:

• Eating and drinking:
  
  
  • Eat a variety of healthy foods such as fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meat and fish. Eating healthy foods may help you have more energy and heal faster. Ask your caregiver if you need to be on a special diet.
    
    
  • Men 19 years old and older should drink about 3.0 Liters of liquid each day (close to 13 eight-ounce cups). Women 19 years old and older should drink about 2.2 Liters of liquid each day (close to 9 eight-ounce cups). Follow your caregiver's advice if you must change the amount of liquid you drink. For most people, good liquids to drink are water, juices, and milk. If you are used to drinking liquids that contain caffeine, such as coffee, these can also be counted in your daily liquid amount. Try to drink enough liquid each day, and not just when you feel thirsty.
  
  
• Start exercising: Talk to your caregiver before you start exercising. Together you can plan the best exercise program for you. It is best to start slowly and do more as you get stronger. Exercising can help make your heart stronger, lower your blood pressure, and keep you healthy.
  
  
• Quit smoking: It is never too late to quit smoking. Smoking harms the heart, lungs, and the blood. You are more likely to have a heart attack, lung disease, and cancer if you smoke. You will help yourself and those around you by not smoking. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.
  
  
• Avoid stress: Stress may slow healing and cause illness. Since it is hard to avoid stress, learn to control it. Learn new ways to relax, such as deep breathing. Talk to your caregiver about things that upset you.

CONTACT A CAREGIVER IF:

• You have a fever (increased body temperature).
  
  
• You feel one or more shocks from your ICD and feel fine afterwards. This means that the ICD is working right, but that you are having arrhythmias.
  
  
• You have swelling of your feet or ankles.
  
  
• The area around your ICD is painful or tender after surgery.
  
  
• The skin around your stitches or staples is red, swollen, or there is drainage. This may mean that you have an infection.
  
  
• You have chills, a cough, feel weak, or achy. These are also signs of infection.
  
  
• Your skin is itchy, swollen, or has a rash. You may be allergic (uh-LER-jik) to your medicine.
  
  
• You are sad or anxious and you find it hard to do your normal activities.

SEEK CARE IMMEDIATELY IF:

• You feel more than three shocks in a row.
  
  
• You become dizzy, faint (pass out), or suddenly feel very tired.
  
  
• You feel your heart skipping beats, beating very fast or slow, but do not feel a shock from your ICD.
  
  
• You start having chest pain that does not go away with rest or medicine.
  
  
• Your stitches or staples come apart.
  
  
• Your bandage becomes soaked with blood.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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