Defibrillator Guidelines

Guidelines for Patients with an Implantable Cardioverter Defibrillator (ICD)

Incision:
Inspect your incision(s) daily and notify the nurse/physician if you notice:

Fever
Incisional pain that increases over time rather than decreases
Increased or continued drainage from incision sites
Swelling, increased redness, bruising, warmth or hardness around the incision(s)
Keep incision dry

DO NOT apply antibiotic ointment
DO NOT remove steri strips

Personal Hygiene:
You may shower 48 hours after your surgery. Avoid exposing your incision(s) to water for about two weeks. Cover the incision with saran wrap to keep dry. Gently wash around the incision with mild soap and water. Pat dry with a clean towel.

Activity:
Gradually increase your activity by walking short distances at frequent intervals. Learn to count your pulse for a full minute. The best place to take your pulse is at the wrist, just below the thumb. Count the number of pulsations in 1 minute. This is your heart rate in beats-per-minute. Remember at what rate your ICD delivers therapy. Keep your pulse at least 15-20 beats below your therapy rate while you are active. Be aware of any symptoms associated with an irregular heart rhythm.

Restrictions:

Do not lift anything heavier than 10 pounds for one month.
Avoid tight belts or other restrictive clothing that may irritate the skin over the pulse generator or lead incision sites.
DO NOT raise the arm on the side of the ICD IMPLANT above the shoulder for 8 weeks. You may move your arm to shoulder level, but DO NOT keep your shoulder stiff or immobile.
Avoid activities that require pushing or pulling for 8 weeks, e.g. vacuuming, mowing the lawn, raking, hoeing, sawing, moving furniture, laundry, bowling, or golf. Ask if you have any specific activity questions. Avoid any activity that involves rough contact with your ICD system.

Medications:
Always take your medication as prescribed by your physician.

What to do if you receive a shock:
If you do not feel well and/or you receive multiple shocks Go immediately to the emergency room of the nearest hospital and have a family member or friend notify us.

If you feel fine and/or you notice a change in the frequency of shocks, e.g. sudden increase or decrease, please notify us as soon as possible.

REMEMBER, WHEN IN DOUBT, CALL!!!!

Medic Alert:
Medic Alert forms are available at our office. You may want to get a bracelet or neck chain to wear.

Sexual Activity:
Sexual activity may be resumed after 2 weeks. The person with the ICD should assume a passive role.

Diet:
There are no specific diet restrictions for an ICD implant. You are advised to follow a "Healthy Heart" diet and observe any previous dietary restrictions. You should avoid chocolate and all other forms of caffeine. Drink decaffeinated coffee and caffeine-free drinks. Caffeine can trigger cardiac arrhythmias in some patients.

ICD Identification Card:
A temporary ID card will be given to you prior to discharge. A permanent identification card will be mailed to you from the manufacturer of your ICD. This card may take up to tow months to arrive. Your ID card should be carried with you at all times.

Travel:
When you travel by airplane, present your ID card at the security check and ask to be cleared for passage with a hand search only. Avoid the hand-held scanning devices and the walk-through airport security systems. Before traveling, check with the MCVI Device Clinic Nurse for advice in case of an emergency. If you are going out-of-state for the winter, we can give you names of doctors who could check your device while you are away form home. If you are moving, we can give you names of Electrophysiologists and arrange to transfer your ICD follow-up to their clinic.

Returning to work:
Your physician will determine when you may return to work. NO DRIVING, BECAUSE YOUR ARRHYTHMIA MAY CAUSE YOU TO LOSE CONSCIOUSNESS OR IF YOU RECEIVE A SHOCK WHILE DRIVING, YOU COULD HAVE AN ACCIDENT AND INJURE YOURSELF, YOUR PASSENGERS, OR OTHERS.

Environmental Restrictions:
Your ICD is made to protect it from most interference produced by any electrical appliances in your home. You can continue to safely operate most appliances and tools that are properly grounded and in good repair, including:

Microwave ovens
Television, cable TV, AM/FM radios, VCR's
Small kitchen appliances
Washer, dryer, electric stove
Hand held items such as hair dryers, electric shavers/razors electric blankets, heating pads
Spark ignited internal combustion engines, such as lawn mowers, leaf blowers
Hand tools: drills, table saws (unless magnetizes)
Garage door openers

AVOID:
Do not place a magnet on or near your ICD pulse generator unless instructed by your physician.

Avoid close exposure to strong electrical, radio, and magnet fields. The Device Clinic Nurse will discuss this information with you when you see her in the office. She will review the following list. If you have any questions, please call MCVI and ask for the Device Clinic Nurse.

Arc welding
Magnets or magnet wands
Airport security hand-held wands
Bingo wands
Stereo speakers
Battery operated cordless power tools
MRI (magnetic resonance imaging) -- a diagnostic test performed in a hospital
Diathermy
Electro-cautery (used during surgery to stop bleeding)
Large generators and power plant
Cellular phones
Antennas typically used in the operation of ham or CB radios
Industrial equipment
Induction furnaces
Radar stations
Avoid leaning over running motors
Security devices (do not stand in the doorways of stores, but you can walk through the doorway)

If you suspect your work environment may contain strong energy fields, please call the MCVI Device Clinic to discuss this with the Nurse. She can answer your questions and address your concerns.

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