AFTER A DEFIBRILLATOR IMPLANT

Discharge Instructions

For your safety, a responsible adult must drive you home after the procedure. The medication you received during the procedure makes you drowsy. We wish you a very speedy recovery. Here is some important information about caring for yourself when you go home.

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Implant Site Discomfort

You may feel discomfort at the device implant site during the first 48-72 hours after the procedure. The doctor or nurse will tell you what medications you can take for pain relief. Please tell your doctor or nurse if your symptoms are prolonged or severe.

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Taking care of your wound Site

Proper care of postoperative incisions will greatly enhance the healing process. Keeping the area clean and well cared for will decrease risk of infection.

  • Remove the large dressing over the ICD, the morning after discharge if the dressing was not removed in the hospital. Do not remove the steri strips, they will either fall off or we will remove them at your 2 week follow up appointment.
  • Shower as usual the morning after discharge protecting the incision site with help of a plastic wrap. It is ok to get the incision and steristips  wet.
  • Subsequent days it is OK to  wash/rinse the site gently with soap, don’t scrub the incision area, gently dry with a clean towel (do not rub).
  • Avoid submerging your wound in a bathtub, swimming pool or Jacuzzi for 6 weeks.
  • Some discomfort such as mild redness, itching and swelling may occur. These symptoms are part of the normal healing process. Don’t scratch the wound if it starts to itch.
  • Protect your incision area from excessive sunlight.

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When to Call Your Doctor

Call your physician right away if you have any of these signs of infection:

  • Any drainage, bleeding or oozing from the insertion site
  • opening of the incision where the device was implanted
  • Redness, swelling or warmth around the device insertion site
  • Increased body temperature (greater than 101 degrees Fahrenheit or 38.4 degrees Celsius)
  • Increasing discomfort related to the wound.

If  you are experiencing symptoms that might be related to your pacemaker such as

  • dizziness,
  • palpitations,
  • fast or slow heart beats

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What shall I do if I experience a ICD Shock?

  • Call the office and talk to the on call physician if you experience a defibrillator shock.
  • If you receive more then one  ICD shock call 911 and paramedics will take you to the nearest emergency room. Inform your doctors office and he will see you in the hospital.

 

 

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Are there any activity restrictions?

These activity guidelines should be followed the first week after your procedure:

  • You may move your arms normally and do not have to restrict arm motion during normal activities. However, do not lift your elbow above shoulder level.
  • Do not lift objects that weigh more than 10 pounds for 6 weeks after the procedure.
  • Avoid activities that require pushing or pulling heavy objects, such as shoveling the snow or mowing the lawn.
  • Stop any activity before you become over-tired.
  • For 6 weeks after the procedure, avoid golfing, swimming, tennis and bowling.
  • Try to walk as much as possible for exercise.

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Will any electrical devices interfere with my device?

  • Electric blankets, heating pads, and microwave ovens can be used and will not interfere with the function of your pacemaker.
  • A cellular phone should be used on the side opposite of where the device was implanted. Cellular phones should not be placed directly against the chest or on the same side as your device.
  • You will need to avoid strong electric or magnetic fields, such as: some industrial equipment, ham radios, high intensity radiowaves (found near large electrical generators, power plants, or radiofrequency transmission towers), and arc resistance welders.
  • In strong magnetic fields, the device stops monitoring your heart rhythm. Once you are out of these fields, normal device function resumes and there is no damage to the device.
  • If you must pass through entrances where anti- theft devices are being used, be sure to walk quickly through them.
  • Do not undergo any tests that require magnetic resonance imaging (MRI).
  • Your doctor or nurse can provide more information about what types of equipment may interfere with your device.

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Pacemaker ID CARD

You will receive a temporary ID card that tells you what type of pacemaker/defibrillator and leads you have, the device manufacturer, the date of the device implant and the doctor’s name who implanted the pacemaker. Within one month you will receive a permanent ID card from the device company. It is important to carry this card in case you need medical attention.

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When can I go back to work?

Your doctor or nurse will tell you when you can go back to work.

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When should I follow-up?

  • Call (602) 456 2342 to schedule this appointment if one was not made for you at the time of your discharge from the hospital. After the initial appointment you will have a important appointment in 3 months for defibrillator check when adjustments will made to the programming to increase device longevity. Please call our office and confirm your appointment.
  • The pacemaker/ICD check is performed at the Device Clinic and takes about 15 to 30 minutes.
  • This first follow-up appointment is critical, because adjustments will be made that will prolong the life of your pacemaker. This appointment is for a device check with the electrophysiology nurse. If you need to see your doctor for follow-up care, you will need to schedule a separate appointment.
  • An echocardiogram may be performed as part of your first follow-up evaluation.

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Will I need antibiotics before Dental work?

We recommend you take an antibiotic before dental work or surgery for 6 months.

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How often do I need device checks?

After your first follow-up appointment, your pacemaker should be checked every 3 months from home, using a telephone transmitter. You will receive instructions on how to use the telephone transmitter in the Device Clinic.

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How long will my device last?

Defibrillators usually last 5-8 years, depending on how often it is used. When the battery becomes low, the pacemaker will need to be changed. By keeping your follow-up appointments in the Device Clinic, your health care team can monitor the function of your device and anticipate when it needs to be changed.

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CAN I DRIVE AFTER ICD IMPLANT?

Commercial driving

Recommendations are most clear for commercial driving: it is permanently prohibited, whatever the clinical circumstances leading to ICD therapy.

Noncommercial driving

ICD patients who have not had symptomatic ventricular dysrhythmias can resume driving after 1 to 2 weeks, much like patients who receive pacemakers. The guidelines regarding driving are (and should be) less restrictive for patients who have received an ICD but have never had an episode of arrhythmia affecting consciousness.

ICD patients who have had nonsustained (short episodes which resolve within seconds) symptomatic arrhythmias should not drive for 3 months after implantation.

Patients who received an ICD after an episode of sustained symptomatic ventricular dysrhythmias should not drive for at least 6 months.

Episodes restart the clock. Anytime after the initial driving restriction that the patient experiences another episode of ventricular tachycardia or ventricular fibrillation that triggers the ICD, the “clock starts over,” and the patient should abstain from driving for 6 months—long enough to adjust the medical therapy and to judge whether the new regimen is adequate.

Thus, because driving status can change on the basis of the frequency of arrhythmias and their symptomatic consequences, it is recommended you talk to your doctor regarding specific instructions for driving.

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Health Maintanence

Pacemaker therapy is only one part of your treatment program. It is also important for you to take your medications, consume healthy diet, live a healthy lifestyle, keep your follow-up appointments, and be an active member of your treatment team.

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