• Reference Number: HEY-605/2020
• Departments: Cardiology
• Last Updated: 24 July 2020

Introduction

This leaflet has been produced to give you information about your defibrillator (ICD) implant procedure.  It is not meant to replace discussion between you and your doctor.  If after reading it, you require further explanation please discuss this with a member of the healthcare team.

Wound care

There may be some discomfort at first, near where the defibrillator has been fitted. You are advised to take pain relief medication such as paracetamol to ease the discomfort.

Avoid pain relief medication that contain aspirin (although you should take prescribed aspirin in the normal way).

Keep the wound clean and dry and look for signs of swelling, redness or discharge. If you notice any of these or have excessive pain at the wound site you should contact your doctor.

The wound is normally closed with dissolvable stitches or glue, which do not need to be removed. You will be informed by your nurse there are any stitches to be removed.

The dressing (if applicable) should be kept on for 48 hours after the procedure, after which it may be removed.  If the wound is clean and dry it may be left without a dressing.

If you have any concerns about the wound site you can either make an appointment to have it reviewed with the practice nurse at your doctor’s surgery or contact the Implantable Device Clinic directly (01482) 461563.

Once the dressing has been removed you may shower and bathe and female patients may wear a bra as usual.

Identification card and follow-up

You will be given an identification card by the cardiac physiologist when your defibrillator (ICD) is checked on the ward.

It is important you carry this card at all times. In case of an accident, this card will inform those attending to you that you have a defibrillator. This card supplies basic information about your device.

You will receive a follow appointment approximately 8 weeks after discharge then at 6 monthly intervals providing your checks are satisfactory. These clinics are held in the ECG Department at Castle Hill Hospital.

What to do if you think you have received a shock from your device.

During office hours Monday – Friday 9.00am – 5.00pm

If you think you may have had a shock from your device and you feel well you should ring the Devices Clinic (01482) 461563 to arrange to have your device checked.

Outside of office hours –evenings, weekend, Bank Holidays

You can call the Cardiac Monitoring Unit (CMU) on (01482) 461598 for advice on what to do.

If you have a shock (or even think that you may have had a shock) and feel unwell you should always seek urgent medical advice.

Advice

Avoid heavy lifting, raising your arm above shoulder height and physical activities especially golf and swimming for at least 6-8 weeks.

You may return to work when your doctor feels you are fit to do so, this is normally 4-6 weeks post defibrillator (ICD) implant.

Driving restrictions always apply after having an ICD implanted. You will be advised that you cannot legally drive for either 1 month or 6 months (sometimes it may be even longer) after implant, depending upon the reason that your device was fitted. Your cardiologist and cardiac physiologist will have discussed this with you and it is important that you inform both the DVLA and your insurance company that you have had an ICD fitted. Should the ICD deliver therapy for any reason, driving restrictions will apply. These range from 1 month up to 2 years.

Any changes to your medication will be discussed with you prior to leaving hospital.

Suitability for air travel is based on individual consultant advice.

It is important you tell other doctors and your dentist that you have a defibrillator (ICD).

You do not need antibiotics for any dental or surgical procedure unless you have another problem with a heart valve. If in doubt ask your doctor.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Cardiology 5 Day Ward (01482) 461517 / 461518 (Monday – Friday), Implantable Device Clinic (01482) 461563 (Monday – Friday), Cardiac Monitoring Unit (CMU) (01482) 461598 (Out of hours).

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.