Discharge advice for patients with internal cardiac defibrillator (ICD)

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What will happen before I leave hospital?

Your ICD will be checked by a cardiac physiologist, who will then arrange for you to have the ICD checked approximately six to eight weeks after the implant date. They will give you an ICD identification card with the details of your device. Keep this card with you at all times.

You will have an X Ray taken which is checked by a doctor. The nurse will clean the wound and apply a new dry dressing. You should be given two new dressings to take home: please ask the nurse if this does not happen.

How should I care for my wound at home?

Always wash your hands before caring for your wound. Leave the dressing on for the first two days, then replace the dressing and keep covered for a further two days. After this you may leave the wound without a dressing.

Should I limit my activities?

Avoid lifting anything heavy and avoid strenuous physical activities for the first six weeks.

Avoid lifting your arm above your head on the side of the implant until you have your post implant device check at approximately six to eight weeks after your implant.

Talc, deodorant and perfume should not be used near to the wound.

Do not immerse the wound site in water for seven days after the procedure. No hot baths or swimming. Showers are recommended after 24 hours. Do not wash the wound directly.

Driving

• Driving a private car or motorcycle must stop for one to six months depending on the reason for your implant. This will be discussed with you.
• If you hold a LGV or PCV licence then you will be permanently barred from driving professionally.
• You must inform the DVLA that you have an internal cardiac defibrillator and they can give you further advice on any driving restrictions.

Flying

• Always carry your ICD identification card with you and inform security that you have an ICD. Airport screening systems may, very rarely, cause problems with your ICD. Some countries may ask you to go through the security system. If this happens, it is important that you move quickly through the gateway.

Work

• Refrain from work for one week, sometimes longer, depending on your condition and type of job you do.
• If your job involves any strenuous activity, i.e. heavy lifting, then it is advisable to avoid this for longer.
• You should discuss your return to work with your employer and your doctor.

What signs should I look out for?

Keep an eye on the wound site over the next five days. If you have any bleeding or discharge, or notice any redness or swelling, opening of the wound, or excessive tenderness, please contact the Cardiac Care Unit.

If the ICD delivers an electric shock it may feel like a heavy thump in your chest. You need to contact the Cardiac Department so your device can be checked by a cardiac physiologist. If you are feeling unwell after the ICD has delivered a shock, or the device delivers repeated shocks, you should dial 999 to be taken to your nearest Accident and Emergency Department.

How can I prevent a device related infection?

As well as wound care, long term it is important to have good dental hygiene, have regular check ups with your dentist and to avoid body tattoos or body piercings.

What happens next?

A detailed report will be sent to your GP which will be copied to you. You will be seen again in the outpatients clinic. An appointment will be sent to you through the post.

Please help yourself to any of the information booklets available on the ward.

Feel free to talk to your nurse about any concerns you may have or any health education you feel you may benefit from.

Continue to use the nasal Octenisan cream twice a day until the tube runs out.

Contact details for the Cardiac Care Unit

If you have any concerns about your wound site, or specific to your cardiac procedure during your first week at home, please contact us.

Other useful contacts are:

For more general concerns, please contact your GP, or if it is an urgent health issue contact NHS 111 for advise or 999 for paramedic assistance.