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If you receive a Guidant ICD system, Guidant will mail you a wallet-sized patient identification card after you are discharged. (A temporary identification form can be used until you receive the permanent card). Your doctor may also provide an ICD security card. It explains that the metal in your implanted system can trigger alarms at airport security checkpoints. Whether you are getting away for the weekend or running a quick errand, take along your ID cards. They can alert medical and security personnel that you have an implanted ICD system.
Your doctor or nurse will give you specific instructions to follow when returning home. Full recovery from surgery can take from several days or weeks to a few months. It is important that you become actively involved in your own recovery. Follow your doctor's instructions about caring for the implant site and letting your other doctors, dentists and emergency personnel know that you have an implanted ICD system. This is important should the ICD need to be turned off temporarily for medical procedures.
Your doctor will help you decide how soon you can resume your normal activities. Many people find that they gradually return to the lifestyle they enjoyed before the surgery, with the added assurance that the ICD is watching over their heart rhythms. In general, work, hobbies, sexual intimacy, exercise, and travel are just as possible once you have an ICD.
Many people are also concerned about sexual intimacy. For most patients, sexual intimacy is not a medical risk. The natural heart rate increase that occurs during sex is the same as the heart rate increase when you exercise. Exercise testing at the hospital will help your doctor program the ICD system settings so you should not experience shocks during sex. If you do receive a shock during sex, your partner may feel a tingle or a buzz. This happens because a small amount of residual shock energy from the ICD system passes through your skin to the other person. The sensation is not harmful to your partner. Be sure to let your doctor know if this occurs so he or she can consider reprogramming the ICD system.
In some cases, restrictions are used because it is important that you do not harm yourself or your ICD. Depending on your condition, your doctor might ask you to avoid certain activities. A few seconds of unconsciousness during activities such as driving, swimming or boating alone, or climbing a ladder could be dangerous to you or others. The fact that you have an ICD system does not itself restrict such things as driving privileges. Rather, the symptoms caused by your arrhythmia are often the deciding factor in whether you are allowed to drive. Your doctor or nurse will discuss any driving restrictions with you, as well as other guidelines.
Once you have an ICD, it is very important to follow your doctor's guidelines for follow-up visits. They typically occur every three months. These visits allow your doctor to check that your device is working properly. Also, your heart condition can change over time, and regular follow-up visits help make your doctor aware of changes and needs for adjustments.
At a typical follow-up visit, your nurse or doctor will check the ICD's settings, collect information stored in its memory and adjust the device's programming if necessary. This is done simply and painlessly with a computerized device that "talks" to the pulse generator with radio signals. Your doctor can also check whether the drugs you might be taking affect how well your ICD system works.
In addition, your doctor or nurse will use this time to check the energy in the ICD's battery. Just like any type of battery, your pulse generator's battery will wear down over time. How long your ICD pulse generator lasts depends on what settings your doctor programs and how much therapy you receive. If the battery energy is low, plans to replace the pulse generator should be made.
Once you have an ICD, it is also very important to follow your doctor's guidelines for when to call the office. Before you experience symptoms or receive shock therapy, it's important to discuss a plan for contacting emergency personnel and your heart doctor. If you have symptoms of a fast heart rate, it is likely that the ICD system will deliver therapy within a few seconds. There usually isn't much time to react.
Your doctor will tell you whether it is necessary to call the office if you receive a shock. Keep in mind that a shock treatment means your ICD system is doing its job. It sees a dangerous rhythm and returns the heart to a normal rhythm.
It is possible that you could feel symptoms and not receive therapy. This depends on the programmed settings of your ICD system. Sometimes exercise may cause shortness of breath, dizziness, or lightheadedness. At other times, an abnormal heart rhythm may cause symptoms that your ICD system is not programmed to treat. In either case, if symptoms are severe or continue for more than a minute or so, you should seek immediate medical attention.
It's natural to feel anxious about the device at first. You have experienced something new and very stressful – an event that changed your thoughts and feelings about your health. Having the ICD system is positive because it can treat your arrhythmias. However, some people feel vulnerable because they depend on an implanted device. The good news is those feelings generally don't last. As you return to daily life, your level of confidence and comfort with the ICD will grow.
Guidant encourages you to discuss your case with your doctor to develop a good understanding of your particular situation. Many patients find that encouraging friends and family to learn about the ICD system is helpful as well.
A defibrillator can be programmed to treat a variety of arrhythmias. When the defibrillator acts as a pacemaker, you generally don't feel anything because it uses low energy to pace the heart. When a defibrillator shocks the heart, it uses higher energy giving a feeling that has been described as a "kick in the chest." Many patients are unconscious when the shock is delivered and don't remember the shock at all. The shock comes quickly and lasts only a second.
With all the technological gadgets in our everyday lives, many patients and their families have questions about the potential interaction between an ICD and electromagnetic fields in the environment. An electromagnetic field consists of invisible lines of force resulting from electricity use, such as devices plugged into an outlet or operated by a battery. If such a field is strong enough, it may interfere with the operation of an ICD system, although this happens on very rare occasions.
A general rule of thumb is for patients to keep their distance from devices that generate large amounts of electromagnetic interference (EMI), such as arc welders and large electrical generators. But the vast majority of electrical items a patient may come in contact with present no problem.
To learn whether specific devices or procedures may interfere with your device, read about Sources of EMI.
You are encouraged to call Guidant Technical Services at 1-866-GUIDANT (1-866-484-3268) with questions about EMI.
The replacement surgery is a minor, simple operation. Your doctor will open the pulse generator skin pocket and unplug the leads. These leads will be tested to make sure they will continue to work properly with the new pulse generator. After testing, the leads are connected to the new ICD pulse generator and the pocket is closed.