Discharge advice for patients with internal cardiac defibrillator (ICD)

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 will be given two dressings to take home: please ask the nurse if this doesn't happen.

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

Avoid lifting any heavy objects or strenuous physical activities for the first few weeks.

Avoid lifting your arm above your head on the side of the implant until you have your post implant check.

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: visit www.gov.uk/defibrillators-and-driving.

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.

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.

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.

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.

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

Telephone number: 01273 696955, extension 4484. You can call this number at any time.

Please call the Cardiac Device Team if you think your device has given you a shock:

Cardiac Device Team: 01273 696955, extension 4090. Monday to Friday, 9am to 5pm.

Email:pacemaker.clinic2@nhs.net

Other useful contacts are:

Arrhythmia Nurses: 01273 696955, extension 7041. Monday, Tuesday, Thursday, Friday, 8am to 4pm

Email: bsuh.arrhythmia.nurses@nhs.net

Cardiac Rehabilitation Nurses: 01273 696955, extension 4009. Monday to Friday, 8am to 5pm.

For more general concerns, please contact your GP