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Pacemaker or ICD Replacement: What to Expect at Home

Inside view of heart in chest, with placement of pacemaker or ICD nearby and lead from device through blood vessel to inside of heart

Your Recovery

Pacemaker or implantable cardioverter-defibrillator (ICD) replacement is surgery to put a new heart device in your chest. The battery in your new device is fully charged. It should last for several years. Your doctor may have also replaced the wires (leads) from the device to your heart, if needed.

Your chest may be sore where the doctor made the cut (incision) and put in the device. You also may have a bruise and mild swelling. These symptoms usually get better in 1 to 2 weeks. You may feel a hard ridge along the incision. This usually gets softer in the months after surgery. You may be able to see or feel the outline of the device under your skin.

You will probably be able to go back to work or your usual routine within 1 week after surgery. It may take as long as 2 weeks if your leads were also replaced.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

  • Rest when you feel tired.
  • Be active. Walking is a good choice.
  • If you also had your leads replaced, then for about 2 weeks:
    • Avoid activities that strain your chest or upper arm muscles. This includes pushing a lawn mower and mopping floors. It also includes swimming and swinging a golf club.
    • Do not raise your arm (the one on the side of your body where the device is located) above your shoulder.
  • Allow your body to heal. Don't move quickly or lift anything heavy until you are feeling better.
  • Ask your doctor when it is okay for you to have sex.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
  • If you take aspirin or some other blood thinner, ask your doctor if and when to start taking it again. Make sure that you understand exactly what your doctor wants you to do.
  • Be safe with medicines. Read and follow all instructions on the label.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

  • Use ice packs for the first 24 hours.
  • If you have strips of tape on the cut (incision) the doctor made, leave the tape on for a week or until it falls off.
  • You may shower 24 to 48 hours after surgery. Pat the incision dry. Don't swim or take a bath for the first 2 weeks, or until your doctor tells you it is okay.
  • You will have a dressing over the incision. A dressing helps the incision heal and protects it. Your doctor will tell you how to take care of this.

Other instructions

  • Keep a medical ID card with you at all times that says you have a heart device. You'll get an updated one with information about your new device. The card should include the manufacturer and model information.
  • Wear medical alert jewellery stating that you have the device. You can buy this at most drugstores.
  • Check your pulse as directed by your doctor.
  • Have your device checked as often as your doctor recommends. In some cases, this may be done over the phone or online. Your doctor will give you instructions about how to do this.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have trouble breathing.

Call your doctor or nurse call line now or seek immediate medical care if:

  • You are dizzy or light-headed, or you feel like you may faint.
  • You have pain that does not get better after you take pain medicine.
  • You hear an alarm or feel a vibration from your heart device.
  • You have loose stitches, or your incision comes open.
  • Bright red blood has soaked through the bandage over your incision.
  • A lump starts to form at or near the incision site.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

  • You have any problems with your device.

Adapted with permission from copyrighted materials from Healthwise, Incorporated (Healthwise). This information does not replace the advice of a doctor. Healthwise disclaims any warranty and is not responsible or liable for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.