Patient Education CARE AND TREATMENT An ICD can protect you against dangerous abnormal heart rhythms. Understanding Your ICD Your doctor has discussed the need for an Implantable Cardioverter Defibrillator (ICD) with you. The purpose of this booklet is to explain: What an ICD is. How it can help you. Needed follow-up after placement. You can also find a video about ICDs on the hospital Patient Education Television. Ask your nurse for details. The ICD is a device that can protect you against dangerous abnormal heart rhythms by constantly monitoring your heart rhythm. The ICD is able to detect ventricular tachycardia (VT) or ventricular fibrillation (VF). These two heart rhythms can be life-threatening if they are not treated. The ICD treats these rhythms by pacing or shocking the heart back to a normal rhythm. The ICD can also act as a pacemaker. Your doctor will program your ICD to best fit your specific needs. ICD Placement The ICD placement is done in the Electrophysiology (EP) Lab. You will be given sedation to help you relax during the procedure. The procedure lasts several hours. Most patients are able to go home the next morning. Life with Your ICD at Home When at home you will need time to recover from the surgery. It is important for you to listen to your body and rest when you feel tired. Eat a proper diet and follow-up with your doctor for scheduled appointments. After you recover, you may resume your normal activities with a few restrictions. Patients First
Incision Care Notify your surgeon if you develop signs of infection: - Fever greater than 100º F. - Redness, swelling or tenderness at the incision site. - Drainage from the incision site. Showering is not permitted until after your wound check appointment (one week after surgery). Allow steri-strips (the clear strips of tape) to fall off naturally. Protect your incisions from the sun to avoid sunburn and decrease scarring. Activity Guidelines Driving is not allowed for 1 week to 6 months after your ICD is implanted. This is a topic of concern for most patients. However, it is important to know that you have a heart rhythm that can make you dizzy, faint or even pass out. If you are driving a car when this happens you could injure yourself or others on the road. The ICD is able to treat the abnormal heart rhythm, not prevent it from happening. Exercise is encouraged. It is important to start slowly and progress gradually. You can check your heart rate by taking your pulse before and after exercise. Be sure to rest when you are tired. There are many benefits to a regular exercise program. Talk to your doctor to see what options are best for you. You should avoid exercise or activity that could result in blunt blows to the ICD, such as contact sports. Avoid swimming for 6 weeks until the incision is completely healed to decrease the risk of infections. You should avoid lifting objects over 10 pounds (groceries, laundry, children, etc.) until 6 weeks after surgery. Sexual intercourse may be resumed. An ICD shock during intercourse may be felt by your partner. In any case, it will not harm either of you. Avoid dental work for 3 months. 2
Magnets and Your ICD You should stay away from strong magnetic fields. Magnets may deactivate your device, drain your battery or even cause unnecessary shocks. For this reason, it is best to avoid magnets or keep a safe distance from them. A partial list of potential concerns include: Source (Outside Hospital) Confirm Safety Safe Arc Welders 4 Large transformers 4 Metal Detectors* 4 Store Security 4 Dental Equipment** 4 Ham/CB Radios 4 Small Hand Tools 4 Microwave Ovens 4 TV Satellite Dish 4 Exercise Equipment 4 Source (Inside Hospital) Confirm Safety Safe MRI Cannot be done Ultrasound 4 Diagnostic Radiation 4 * Metal detectors will not hurt your device; however, they will set off the alarm. Hand held wands should be avoided. ** Dental equipment is safe with a few exceptions. Notify your dentist about your ICD before any procedure is performed. As suggested, confirm the safety of the indicated items. Individual situations may vary. If in doubt, your home or work area can be checked for interference with your device by consultants (ask the Device Nurse Clinicians for details). It is important to notify your doctor(s) that you have an ICD. If there are any questions concerning specific tests we can provide you with further information. 3
Follow Up Care After your ICD is implanted you will be followed closely by your doctor to assure that it is working properly. You will have an appointment every 3 months in the outpatient office or via remote transmitter through your telephone. During this visit we check the battery status and the ICD function. This test is short and painless. This is also a good time for you to share any questions or concerns you might have. The outpatient office is located at 675 North St. Clair, 19th floor, Suite 100. The appointment phone number is 312-695-4965. If You Have a Shock As noted before, your ICD may attempt to pace you out of an abnormal rhythm. If unsuccessful it will deliver a shock to restore your normal rhythm. If you receive a shock and pass out or do not feel well, call 911 or your local emergency number. Once transferred to an emergency department, notify us at Northwestern Memorial Hospital, 312-695-4965. If You Receive a Shock and Feel Fine You may want to sit and rest for a few minutes. Notify us at Northwestern Memorial Hospital when you have time. Call the EP nurses at 312-695-4965. Appointments You will need to come back in 1 week for a wound check. Your wound check is scheduled for:. Please come to the Galter Pavilion, 675 North St. Clair, 19th Floor, Suite 100. The appointment should take about 15 minutes. The electrophysiologist will want to check your device 3 months after surgery. Your 3-month ICD check is scheduled for:. Do not eat or drink anything the morning of the test. You may take your medicines with a small amount of water that morning. You need to check in at the Feinberg Pavilion, 251 East Huron, 8th Floor reception desk at 7:00 am. Plan to be in the hospital until about 1:00 PM that day. Please arrange for someone to drive you home. You should not be driving or taking public transportation alone because of the sedation medication you will receive during the test. After the 3-month test you will be seen in the outpatient clinic every 3 months. The ICD clinic is located at the Galter Pavilion, 675 North St. Clair, 19th Floor, Suite 100. The appointment phone number for clinic is 312-695-4965. 4
For further information about your ICD feel free to call the EP Nurses at 312-695-4965. Health Information Resources For more information, visit Northwestern Memorial Hospital s Health Learning Center. This state-of-the-art health library is located on the 3rd floor of the Galter Pavilion. Health information professionals are available to help you find the information you need and provide you with personalized support at no charge. You may contact the Health Learning Center by calling 312-926-LINK (5465) or by sending an e-mail to hlc@nmh.org. For additional information about Northwestern Memorial Hospital, please visit our Web site at www.nmh.org. Para asistencia en español, por favor llamar al Departamento de Representantes para Pacientes al 312-926-3112. Northwestern Memorial is an equal opportunity employer that welcomes, respects and serves with dignity all people and does not discriminate, including in hiring, or employment, or admission, or access to, or treatment in its programs or activities on the basis of race, color, gender, national origin, religion, disability, handicap, age, Vietnam or other veteran status, sexual orientation or any other status protected by relevant law. To arrange for TDD/TTY, auxiliary aids and foreign language interpretation services, or for issues related to the Rehabilitation Act of 1973, call the Patient Representative Department at 312-926-3112, TDD/TTY number 312-926-6363. Developed by: Electrophysiology Nursing Staff January 2013 Northwestern Memorial Hospital For more information about Northwestern Memorial Hospital, please visit www.nmh.org. 1100-07 900720 (01/13)