Statement of Values

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• Support Services
• Cardiac Rehabilitation (CR) is a programme of
  exercise and education that may be suitable for
  you to attend. It is an 8 week group based
  programme which helps you with returning to
  normal activities and regaining your confidence.
• Please contact 414 3097 for further information.
  Cardio-pulmonary resuscitation (CPR) training is
  offered to patients and family members who attend
  the CR programme.
• You will get an opportunity to meet other
  patients who have an ICD through the Irish Heart
  Foundations ICD Support Group. Ask the nursing
  staff for this information or contact the Irish
  Heart Foundation on 01 6685001
• If you have any questions feel free to contact
  your Cardiology Team through the hospital
  switchboard - 01-4142000.
• Emergency Telephone Numbers (keep these numbers
  by your phone or in mobile phone)
• Cardiac Technicians (Mon Fri 0830 hrs 1700
  hrs)
• 01-4143349 / 01-4143042
• Outside of the above hours
• Accident Emergency 01-4142000 / 01-414 3501
• This booklet was produced
• by

Implantable Cardioverter Defibrillator (ICD) A
patient information booklet
Statement of Values Respect - Caring - Openness -
Partnership - Teamwork Fairness Equality
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• This booklet is designed to provide you with
  relevant information regarding an Implantable
  Cardioverter Defibrillator (ICD).
• What is an ICD?
• An ICD is a medical device that is implanted just
  below your collar bone (usually left) to monitor
  and, if necessary, correct episodes of an
  abnormal heartbeat (arrhythmia).
• The ICD can treat 3 types of arrhythmia.
• 1) The ICD contains a built in device known as a
  pacemaker, which can speed up a slow heart rate.
• 2) The ICD can spot a fast heart rate and the
  pacemaker can over-ride the fast heart rate
  (without giving a shock), to return the heartbeat
  to a normal rate. This is known as anti-tachy
  pacing.
• 3) The ICD can spot a very fast or potentially
  dangerous heartbeat disturbance and deliver an
  electrical shock which brings the heart back into
  normal rhythm. This is known as defibrillation.

• Medical / Dental procedures
• Some medical equipment, especially if used for
  cauterizing (burning used to control bleeding
  during an operation or procedure), could affect
  the way the ICD works.
• If you are having a surgical or dental procedure
  you should make the treating doctor aware that
  you have an ICD.
• Returning to a normal pattern of life
• You may return to your normal everyday activities
  as soon as you feel able.
• For the first week do not raise your left arm
  above your head, however it is important that you
  do gentle arm and shoulder exercises to prevent
  frozen shoulder.
• Avoid heavy lifting and strenuous sports until
  discussed with your Doctor after the procedure.
• Avoid golf for 6 weeks.
• When to resume sexual activity
• You may resume sexual activity when you feel
  able.
• The ICD allows for a rise in heart rate without
  automatically discharging a shock.
• If your heart rate rises to a very fast rate the
  ICD will not discharge a shock unless an abnormal
  heart rhythm is also present.
• If your ICD discharges a shock the other person
  will not be affected.

• The Procedure
• Takes about one hour. You will be given local
  anaesthetic, sedation (sleep inducing) and
  painkillers to make you feel more comfortable.
• The ICD system has 1, 2 or 3 wires (also called
  leads) and a battery box with in-built computer
  (also called the pulse generator). The number
  of wires used depends on the type of ICD your
  doctor has decided you need. The wire(s) are
  passed down to the heart through a vein under the
  collar-bone. The battery box is usually placed
  under the skin beneath the left collarbone, where
  you will have a small scar.
• All information including the possible
  complications and side effects of this procedure
  will be discussed with you by your doctor
  beforehand. The device will usually be tested
  during the procedure you will be deeply asleep
  (sedated) and not aware of this.

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Driving Advice Driving guidelines are not the
same for all those with an ICD. Your driving
advice is (if not written here driving advice
will be discussed with you by your
Doctor) __________________________________________
_______________ __________________________________
__________________________________________________
__________________________________________________
_____________________________________

• You will need to inform your insurance company
  and driving licence authority that you have an
  ICD in place. If you drive as part of your work
  you should discuss this with your doctor.
• Magnetic fields
• Electromagnetic fields will not damage your ICD
  but they may stop it working temporarily while
  you are in the field. This is not a problem with
  small household magnets, fridge magnets etc. To
  avoid problems you should
• Avoid large magnetic fields or strong magnetic
  elements such as phone masts or ESB power
  stations.
• The stronger the electrical current the further
  distance away you should maintain
• You cannot have an MRI scan (but you can have
  other X-ray scans).
• You CAN use a mobile phone, but do not keep your
  mobile phone in a breast pocket beside the ICD.
• You can use an Mp3 player (i.e. iPod) but do not
  keep it in a pocket or arm pouch near the ICD.
• It is safe to use microwaves.
• Electric Arc Welding requires specific advice
  please speak to your Doctor

Picture supplied by PEI

• Before the procedure
• Do not eat or drink from 12 midnight the night
  before your procedure
• If you take warfarin this will need to be stopped
  before the procedure. Your doctor will need to
  discuss this with you.

• After the procedure
• Many patients will be discharged within 2-3 hours
  after the procedure.
• Occasionally it may be necessary to stay in
  hospital longer for other tests or treatment.

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• What do you do if your ICD discharges a shock?
• Your ICD may never need to shock you. If you do
  get a shock
• Remember a shock is good!!! It may save your life
• It will usually feel like a thump in the chest.
• If you receive one shock, compose yourself, see
  how you feel and call the medical team or the
  pacing clinic at the hospital.
• If you get one shock and feel OK, then this call
  can be made during office hours. (see support
  services on p8)
• If the ICD gives you more than one shock or if
  you feel dizzy, pass out, have chest pain or are
  unwell then dial 999 and call an ambulance.
• DO NOT drive yourself to the hospital

• Wound Care
• Keep the wound area dry for seventy two hours
  avoid having a shower or bath for this time.
• Keep a dressing over the wound area for one week
  after the procedure.
• The stitches in the wound are dissolvable (so
  they do not need to be removed), but sometimes
  the ends may need to be removed. If there are
  still stitches showing after 2 weeks you should
  see your GP.
• If you notice that the area around the wound is
  red, hot or swollen you need to attend your GP
  and inform the Cardiac Technicians. (see support
  services p 8.)
• Dressings can be changed after each shower once
  the surrounding skin is dried with a clean towel.
• You may be supplied with dressings before you
  leave the hospital. They are also available from
  your local pharmacy.
• Follow Up Care
• Painkillers will be prescribed as directed by the
  doctor.
• Before you leave the hospital you will be given a
  follow up appointment card for 6 weeks time, and
  6 monthly there after.

• ICD Travel
• You will get a card (or passport) with all the
  information about your ICD. Always have the
  original or a copy of the card with you, it holds
  important medical information. This is
  particularly important if you are travelling.
• Keep an up to date list of any medications you
  are taking with your ICD Card.
• Inform airport security that you are advised not
  to pass through the scanner (they may ask to see
  your ICD card and will do a manual search
  instead).

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