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Removal Of Implantable Cardioverter Defibrillator

AMBULATORY CARE:

Removal of an implantable cardioverter defibrillator (ICD)

may be needed due to infection around the device or in the heart tissue.

How to prepare for ICD removal:

Your healthcare provider will talk to you about how to prepare for surgery. He may tell you not to eat or drink anything after midnight on the day of your surgery. He will tell you what medicines to take or not take on the day of your surgery. Arrange for have someone drive you home and stay with you after the procedure. You will not be able to lift anything heavy for several days after ICD removal. Ask your healthcare provider when you can return to work after your procedure.

What will happen during ICD removal:

You may be given general anesthesia to keep you asleep and free from pain during surgery. You may instead be given IV sedation and local anesthesia to numb the surgery area. With local anesthesia, you may still feel pressure or pushing during surgery, but you should not feel any pain. IV sedation will help you relax during the procedure. Your healthcare provider will make an incision in your chest and remove all parts of the ICD. He may remove infected tissue or take a sample to test for the type of germ causing infection. He may also place a drain to allow the infection to heal. He may close the incision with stitches or staples and place a bandage over your incision.

What will happen after ICD removal:

You will be taken to a recovery room where you will rest until you are awake. You will be on a heart monitor. A heart monitor is an EKG that stays on continuously to record your heart's electrical activity. You may be able to leave when you are awake and your pain is controlled or, you may go to a hospital room. You may need to stay on a heart monitor in the hospital until your infection is gone and you can have another ICD placed. You may need special wound care to help your infection heal. You may also need several weeks of IV antibiotic therapy.

Risks of ICD removal:

You may bleed more than usual or get a blood clot after surgery. Your heart or blood vessels may be damaged and you may need more surgery. You may also need a wearable cardioverter defibrillator (WCD), or temporary transcutaneous pacing, to prevent a cardiac arrest. A cardiac arrest is when your heart stops beating. You may need to have another ICD placed after your infection is gone.

Call 911 or have someone else call for any of the following:

  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest that lasts longer than 5 minutes or returns
    • Discomfort or pain in your back, neck, jaw, stomach, or arm
    • Trouble breathing
    • Nausea or vomiting
    • Lightheadedness or a sudden cold sweat, especially with chest pain or trouble breathing
  • You have trouble breathing.
  • You lose consciousness or stop breathing.

Seek care immediately if:

  • Blood soaks through your bandage.
  • Your stitches come apart.

Contact your healthcare provider if:

  • You have a fever or chills.
  • Your wound is red, swollen, or draining pus.
  • You have nausea or vomiting.
  • Your skin is itchy, swollen, or you have a rash.
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • Heart medicine may be given to strengthen or control your heartbeat.
  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely.
  • Antibiotics help treat an infection.
  • Take your medicine as directed. Call your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Care for your wound as directed:

Wear loose-fitting clothing over your wound. Do not get your wound wet until your healthcare provider says it is okay. Carefully wash the wound with soap and water. Dry the area and put on new, clean bandages as directed. Change your bandages when they get wet or dirty. Do not put powders or lotions over your incision. Check your wound everyday for signs of infections such as swelling, redness, or pus. Empty your drain as directed. Write down how much you empty each time.

Care for yourself at home:

  • Apply ice on your wound for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps prevent tissue damage and decreases swelling and pain.
  • Do not lift anything heavier than 3 pounds. Lifting may put too much stress on your incision. Ask your healthcare provider when you can lift heavy objects.
  • Limit the use of your arm nearest to your wound. Place your arm closest to the wound in a sling. Wear as directed. This will help decrease swelling and pain. Prop your arm on pillows or blankets when you take off your sling to keep it elevated comfortably. Do not lift your arm closest to your wound, over your heard for 5 days. Perform gentle range of motion exercises (ROM) exercises as directed to prevent arm and shoulder stiffness.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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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