Pacemaker/Implantable Cardioverter Defibrillator Insertion

Discharge Instructions

Medications

Before your discharge, your nurse will bring you a list of your medications, as ordered by your physician. You will be given instructions regarding the dosage, schedule, and possible side effects.

Diet

You will most likely be able to resume your usual diet, unless your physician instructs you differently.

Activity

You should be able to return to your daily routine within a few days. Your physician will tell you if you will need to take more time in returning to your normal activities. In addition, you should not do any lifting until your physician advises you to do so. You should also avoid pulling on anything or lifting your arms above your head.

Sexual Activity

You should be able to resume sexual activity once your incision has healed, unless your physician instructs you differently.

Bath Care

You should not take a shower until the incision is healed (usually about 5 days). Wash normally with soap and water, but do not apply unusual pressure at the site of the pacemaker/ICD insertion. Pat dry instead of rubbing the skin around the site.

Site Care

Leave the dressing on the incision for 24 hours. There will most likely be small strips of tape over the incision site (called steri-strips). These strips should be left on as instructed. You will be given additional instructions about cleaning the incision each day. If increased bruising, swelling, or signs of infection (such as drainage, redness, or increased temperature from the site) are noted at the incision site, you should notify your physician immediately.

Driving a Vehicle

Your physician will give you specific instructions about driving. If you had an ICD implanted, there may be additional limitations on your driving. Your physician will explain these limitations to you, if they are applicable to your situation. You should arrange to have someone drive you home from the hospital following your procedure.

Returning to Work

Ask your physician when you will be able to return to work. The nature of your occupation, your overall health status, and your progress will determine how soon you may return to work.

Office Visit

A follow-up visit with your physician will be necessary within four to six weeks after discharge from the hospital. In addition, you will need to see your physician periodically to have your pacemaker or ICD checked. Your physician will give you a schedule for these visits. Some assessments of the pacemaker or ICD device may be done by telephone with the use of a special device that can easily be connected to your telephone.

Identification Card

You will receive an identification card following your procedure. This card will contain your name and other information, as well as the serial number and model of your pacemaker or ICD. It is very important that you carry this identification card with you at all times. The information will be needed if you ever have problems with your device, if you are involved in an accident and need treatment away from your regular physician, if you need to avoid a magnet situation such as metal detection at an airport or other location, and for other possible reasons.

Precautions

In the past, people with pacemakers risked interference with the proper functioning of their pacemakers if they were too close to car distributors, radar, microwaves, electric blankets, and airport security detectors. However, with improvements in pacemaker technology, these issues are no longer of major concern.

The following precautions should always be considered. Discuss the following in detail with your physician:

• Use caution when going through airport security detectors. Check with your physician about the safety of going through such detectors with your particular pacemaker.
  
  
• Avoid magnetic resonance imaging (MRI) machines or other large magnetic fields.
  
  
• Abstain from diathermy (the use of heat in physical therapy to treat muscles).
  
  
• Turn off large motors, such as cars or boats, when working on them (they may temporarily ?confuse? your pacemakeres rate).
  
  
• Avoid certain high-voltage or radar machinery, such as radio or television transmitters, electric arc welders, high-tension wires, radar installations, or smelting furnaces.
  
  
• If you are having a surgical procedure performed by a surgeon or dentist, tell your surgeon or dentist that you have a pacemaker, so that electrocautery will not be used to control bleeding (the electrocautery device can change the pacemaker settings).
  
  
• Always carry an ID card that states you are wearing a pacemaker.

You may have to take antibiotic medication before any medically invasive procedure to prevent infections that may affect the pacemaker.

Always consult your physician if you have any questions concerning the use of certain equipment near your pacemaker.

Once the pacemaker has been implanted, people with pacemakers should be able to do the same activities everyone else in their age group is doing: living normally. When you have a pacemaker, you may still be able do the following:

• exercise moderately, as advised by your physician
• drive your car
• travel
• return to work
• work in the yard or house
• participate in sports and other recreational activities
• take showers and baths
• continue sexual relationships

When involved in a physical, recreational, or sporting activity, a person with a pacemaker should avoid receiving a blow to the skin over the pacemaker. A blow to the chest near the pacemaker can affect its functioning. If you do receive a blow to that area, see your physician.

Always consult your physician when you feel ill after an activity, or when you have questions about beginning a new activity.

Warning Signs/Symptoms to Monitor

Notify your physician if you develop any of the following symptoms:

• dizziness, fainting, or other symptoms that were present before the procedure
  
  
• any redness, swelling, draining, or other signs of infection at the insertion site
  
  
• bleeding from the insertion site

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