Your guide to living with your implantable cardioverter defibrillator

What is an ICD?

ICDs are implanted to protect patients from potentially dangerous, fast heart rhythms. Your ICD can deliver electrical therapy to reset your heart back to a normal rhythm.

The link below gives useful information on the follow up procedure for your implantable cardiac device.

https://youtu.be/jl9BiF5BA68

Aftercare at home

Gentle rotation of your shoulder is advised to prevent it from stiffening up. The area where the ICD is implanted can often be tender after the implant, but this should resolve.

You can remove the dressing five days, after discharge. The wound is routinely closed with surgical glue or steri-strips.

You can shower, but the wound should not be soaked for at least seven days. The glue should be fully washed off within three weeks.

The signs of infection include: redness, swelling, the wound feeling hot to the touch or painful, or discharge from the implant site.

If you are worried about your wound, please contact the device clinic or the ward L14 at the LGI for advice.

Follow-Up

After your implant, the cardiac physiology team will visit you on the ward to check your device, provide information and advise on remote monitoring.

Remote monitoring allows us to check your ICD and reduces trips to hospital. We will alternate between face-to-face and remote appointments. Frequency of follow-up is dependent on a variety of factors, which the cardiac physiology team will advise you on.

We will arrange for you to attend Leeds General Infirmary Hospital approximately 6-8 weeks after the ICD implant. You will be seen by a cardiac physiologist who will check the lead measurements and stored ICD information, and ensure your wound has healed.

Your ICD ID card will be provided at this check.

It is vital that you carry this card with you at all times, as it gives health professionals important information about your ICD.

The cardiac physiology team will utilise the appointments (either face-to-face or remotely) to assess symptoms, the battery life of your ICD and optimise the settings.

These appointments are extremely important to attend, to ensure your ICD is working well.

Getting back to normal

Returning to everyday activities is an essential part of recovery. It is usual for patients to return to work approximately one week, after the implant. If you do a very heavy or physical job we ask that you keep the movements of your shoulder on the side reduced until the first follow-up.

Most individuals can resume normal activities and exercise as soon as they feel able. It is advisable to increase the amount you do gradually. Sports that involve vigorous shoulder movement (such as swimming or golf) can be resumed after three months. Contact sports are best avoided but if you must do these, then padding or protection over the implant site is advised.

Sexual activity

You can resume normal sexual activity as soon as you feel able.

Driving

The rules for driving are set by the DVLA (Swansea SA99 1TU).

These are for your safety and for the safety of other road users.

• You should notify the DVLA if you have received an ICD.
• You will need to complete a form.
• Patients with ICDs fitted following an episode of arrhythmia cannot drive for six months after the implant.
• Patients with ICDs fitted for preventative reasons cannot drive for one month.
• Patients with ICDs are permanently banned from holding a PSV or HGV license.
• Once your ICD is fitted, if the device has to deliver therapy, other driving restrictions may apply.

As with many regulations, things change over time. The latest guidance can be found at https://www.gov.uk/health-conditions-and-driving. If you are unsure, please ask the team for advice.

Electrical interference and ICDs

The risks from most appliances are theoretical risks and do not occur very often.

Most everyday household and office equipment can be safely operated, as there are built in features of the ICD to protect it from most sources of interference.

Industrial equipment may require special precautions.

Handheld appliances and power tools should be kept at least 30cm away from the implant site to prevent any potential interferences.

Large magnets should be kept at arm’s length away.

Please ask our team, if you require further information.

Hospitals & dentists

It is essential to inform your doctor, dentist or surgeon that you have an ICD fitted as some procedures require precautions.

Magnetic Resonance Imaging (MRI) was previously considered to be unsafe but newer ICDs have been designed to operate safely during MRI scans, though specific precautions need to be taken.

CT/CAT, diagnostic X-ray or ultrasound are all safe.

Most dental procedures are also safe (drilling, ultrasound cleaning etc.).

There are certain procedures that may require reprogramming of your ICD; this will usually be arranged by the referrer.

Please speak to your device clinic or cardiologist if you are concerned.

Travelling with an ICD fitted

It is safe to travel on aeroplanes after two weeks.

Please ensure your travel insurance company know about your ICD and that your cover is appropriate.

Caution may be needed near security scanners in airports. Portable wand devices can be safely used providing they are scanned briefly over the device area.

Additional information

ICD battery life varies depending on model and how much they are being used. Regular checks by the device clinic ensure that the battery life is monitored and we will arrange for the generator to be changed, when the time comes.

ICDs go through testing before we are allowed to use them. Like all electronic equipment, unexpected faults may occur from time to time and these would be picked up by the pacemaker team.

If we receive warning of a problem with a particular model of ICDs, we may need to see you more. If there were to be any problems that we felt put you at risk of harm, your cardiologist would talk to you about replacing the device early.

Alerts and alarms

Your device can perform self-checks. If anything changes with the battery or lead measurements, the device can alarm or vibrate. If you think this has occurred, please contact the cardiac devices team. We will demonstrate these alerts prior to discharge.

What to do if your ICD delivers a shock

If you have one shock and feel okay, then you do not need to attend hospital straight away

If your ICD delivers more than one shock, or you have one shock and feel unwell, please call 999.

If you require any advice out of hours, the device team can be contacted via the coronary care unit (Ward L20).

What happens when the generator is changed?

It is not usually necessary to change the leads that are connected to the heart. Therefore the generator change procedure is much quicker than the initial implant.

The old generator is removed and exchanged for a new generator and then tested.

Useful contacts

Other useful numbers/ websites: