Subcutaneous Implantable Cardioverter Defibrillator

Medically reviewed by Drugs.com. Last updated on May 4, 2025.

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A subcutaneous implantable cardioverter defibrillator (S-ICD) is a small device to treat heart arrhythmias. Subcutaneous means the device is placed under your skin. This type of ICD does not use wires placed in the vein or heart. The device has a generator that is attached to a lead (wire). The ICD monitors your heart rhythm at all times. The generator sends electrical shocks if an abnormal rhythm is detected. Some arrhythmias may cause your heart to stop beating suddenly. The device can give a shock to make your heart start beating again.

DISCHARGE INSTRUCTIONS:

Call your local emergency number (911 in the US), or have someone call if:

• You have any of the following signs of a heart attack:
  • Squeezing, pressure, or pain in your chest
  • You may also have any of the following:
    • Discomfort or pain in your back, neck, jaw, stomach, or arm
    • Shortness of breath
    • Nausea or vomiting
    • Lightheadedness or a sudden cold sweat
• You become weak, dizzy, or faint.
• You feel lightheaded, short of breath, and have chest pain.
• You cough up blood.
• You have trouble breathing.

Seek care immediately if:

• Your arm or leg feels warm, tender, and painful. It may look swollen and red.
• Your stitches or staples come apart, or you have heavy bleeding from the incision area.
• The skin around your stitches or staples is red, swollen, or draining pus or fluid.
• You feel a shock from your ICD.

Call your doctor or cardiologist if:

• You have a fever.
• Your feet or ankles swell.
• You have chills, a cough, and feel weak or achy.
• You have questions or concerns about your condition or care.

Drugs used to treat this and similar conditions

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. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
• Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell your provider 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 the incision area:

• Care for the incision area as directed. Wear loose-fitting clothing over the area. Do not get the area wet until your healthcare provider says it is okay. When it is okay to bathe, do not scrub the area. Just let water run over it. 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 the area every day for signs of infection, such as swelling, redness, or pus.
• Do not lift anything heavier than 10 pounds, or as directed. Ask your healthcare provider when you can lift heavy objects.

Safety instructions:

Talk to your healthcare provider about driving and playing sports after you have an ICD placed. The following are general safety instructions:

• Wear medical alert jewelry or carry a card that says you have an S-ICD. Ask your healthcare provider where to get these items. Tell all healthcare providers, including dentists, that you have an S-ICD.
• Stay away from magnets or machines with electric fields. These can interfere with how your ICD works. You will get specific safety information based on the type of ICD you have. You will need to keep cell phones and headphones away from your ICD. General examples of machines to avoid include car engines, welding machines, and electronic body fat scales. You may also need to avoid electrolysis, medical alert systems, or electric fences.
• Tell airport security you have an S-ICD. You may need to be searched by hand when you go through a security gate. The security gate or handheld wand could harm your ICD.
• Keep an ICD diary. You may not notice the low-energy shocks from your ICD, or they may feel like a flutter in your chest. The high-energy shocks are very short. They may feel like thumping or a painful kick in the chest. 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, and how many shocks you received. Write down the day and time of each shock. Bring the diary with you when you see your healthcare provider or cardiologist.
• Plan ahead for device replacements. The battery should last 5 to 10 years. You will need to have a replacement when the battery runs out.

Follow up with your doctor or cardiologist as directed:

You will need to have your ICD checked often to make sure it is working correctly. Your ICD may have a remote monitor that you will take home with you. The monitor sends information from your ICD to your doctor's office regularly. Your doctor may review the information with you during your visits. Write down your questions so you remember to ask them during your visits.

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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.

Further information

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