Implantable Cardioverter-Defibrillator Placement: Before Your Procedure

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What is an implantable cardioverter-defibrillator?

A heart and an implantable cardioverter-defibrillator

An implantable cardioverter-defibrillator (ICD) is a small, battery-powered device. It fixes life-threatening changes in your heartbeat. If the ICD detects a life-threatening heart rhythm, it tries to get it back to normal. If the dangerous rhythm does not stop, the ICD sends an electric shock to the heart to restore a normal rhythm. The device then goes back to its watchful mode.

The doctor puts an ICD in your chest and attaches it to thin wires, called leads. The leads carry the shocks from the ICD to the heart.

Before the procedure, you will get medicine to help you relax. The doctor will make an incision (cut) in the skin just below your collarbone. The cut may be on either side of your chest. The doctor will put the ICD leads through the cut. The leads go into a large blood vessel in the upper chest. Then the doctor will guide the leads through the blood vessel into the heart. The doctor will place the ICD under the skin of your chest. He or she will attach the leads to the ICD. Then the cut will be closed with stitches.

The procedure usually takes about an hour. You may stay in the hospital for 1 or 2 days.

You can likely return to many of your normal activities after you get an ICD. But to stay safe, you may need to make some changes to your normal routine. You will need to be careful with certain types of electronic equipment. And you'll need to take extra care with medical and dental tests and procedures. You will be given specific instructions after getting your ICD.

You may feel anxious or worried about having an ICD. This is common. You might feel better if you use techniques to help you relax. Make a plan for what to do if the ICD shocks you. And think about how the ICD will help you. Talk to your doctor about ways to help ease anxiety.

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 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.

What happens before the procedure?

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

  • Understand exactly what procedure is planned, along with the risks, benefits, and other options.
  • Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your procedure. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your procedure. You may need to stop taking certain medicines a week or more before the procedure. So talk to your doctor as soon as you can.
  • If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of the procedure?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be cancelled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
  • Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • Bring a picture ID.
  • You will be kept comfortable and safe by your anesthesia provider. You may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
  • The procedure will take at least 1 hour.

Going home

  • Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
  • You will be given more specific instructions about recovering from your procedure. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your procedure.
  • You become ill before the procedure (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the procedure.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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