Implant Site Care
You may feel discomfort at the device implant site during the first 48 hours after the procedure. The doctor will tell you what medications you can take for pain relief. Call your doctor or nurse if your symptoms are prolonged or severe.
Keep the area where the device was implanted clean and dry. Do not scrub the area. Steri-strips (small strips of tape) may be covering the wound site; they may be removed 3 weeks after the date of the implant. Do no cover the wound unless you have been instructed to do so. You do not need to keep the wound covered with a bandage. Do not use creams, lotions or ointments on the wound site.
Look at the area daily to make sure it is healing properly. Call your doctor if you notice:
- Increased drainage, bleeding or oozing from the insertion site.
- Increased opening of the incision where the device was implanted.
- Redness, swelling or warmth around the device insertion site.
- Increased body temperature (greater than 101 degrees Fahrenheit or 38.4 degrees Celsius).
You may take a shower 5 days after the procedure.
If the device was implanted in your abdomen, do not wear tight-fitting clothing or belts.
Activity
For the first week after your procedure:
- You may move your arms normally and do NOT have to restrict arm motion during normal activities. However, do not hold your arms above shoulder level for more than several minutes at a time.
- Stop any activity before you become over-tired.
- Try to walk as much as possible for exercise. You should not drive for at least one week after your procedure.
For the first six weeks after your procedure:
- Don't use the affected arm to lift objects that weigh more than 10 pounds for 6 weeks after the procedure.
- Avoid activities that require pushing or pulling heavy objects, such as shoveling the snow or mowing the lawn for two weeks.
- For 6 weeks after the procedure, avoid golfing, swimming, tennis and bowling.
Your doctor will tell you when:
- You can resume driving.
- You can resume more strenuous activities or heavy lifting.
- You can go back to work.
Follow-up & Device Checks
Follow-up Appointments
A follow-up device check appointment will be scheduled within 6 weeks after the implant procedure. The appointment will be scheduled automatically and you will receive an appointment notice in the mail.
The Device check is performed at the Device Clinic and takes about 15 to 30 minutes.
This first follow-up appointment is critical, because adjustments will be made that will help your device last longer. This appointment is for a device check with the electrophysiology nurse. If you need to see your doctor for follow-up care, you will need to schedule a separate appointment.
An echocardiogram may be performed as part of your first follow-up evaluation.
Device Checks
If you have a single or dual chamber pacemaker: After your first follow-up appointment, your pacemaker should be checked every 3 months from home, using either a telephone transmitter or a remote monitoring transmitter. You will receive instructions on how to use the telephone transmitter in the Device Clinic.
If you have a biventricular pacemaker (cardiac resynchronization therapy device - CRT): After your first follow-up appointment, your device should be checked every 3 months from home, using a telephone transmitter or a remote monitoring transmitter. You will receive instructions on how to use the telephone transmitter in the Device Clinic. Your biventricular pacemaker also should be checked every 6 months in the Device Clinic.
If you have an implantable cardioverter defibrillator (ICD): After your first follow-up appointment, your device should be checked every 6 months in the Device Clinic. Your device will allow you to use a remote monitoring transmitter. This lets you check your device every night. You may only need to have it checked in-person once a year. If you can use the remote monitor, you will receive instructions while at the Device Clinic.
Every year, around the anniversary of your device implant, you will have an echocardiogram scheduled along with a complete device check in the Device Clinic. This appointment is different than the telephone transmitter check, since the leads are tested during this appointment.
When to Call the Doctor
Please call 911 if you ever receive several shocks in one day.
Call your health care provider
If you have any of these signs of infection:
- Increased drainage, bleeding or oozing from the insertion site
- Increased opening of the incision where the device was implanted
- Redness, swelling or warmth around the device insertion site
- Increased body temperature (greater than 101 degrees Fahrenheit or 38.4 degrees Celsius)
If you have any of these signs or symptoms:
- Dizziness
- Palpitations
- Fast or slow heart rates
- Lose or nearly lose consciousness before receiving therapy from the device
- Have numbness or tingling of the arm closest to the device
These symptoms may be related to your device. If you have a telephone transmitter please call the transmitter line 7 a.m. to 8 p.m., Monday through Friday to check your device. If you have a remote monitor please call the device clinic between the hours of 6:30 a.m. - 6 p.m. Monday through Friday and we will instruct you to sent us a transmission. You will be provided the phone number prior to leaving the hospital. If these symptoms occur during non-operating hours, you should go to the nearest emergency room.
Device therapy – what to do if you receive therapy from your ICD device
- Stay calm or lie down
- If someone is touching you when the device delivers therapy or fires, he or she may feel a tingling sensation, this is not harmful
- If possible, ask someone to stay with you until you feel better
- If you feel fine after the shock, you do not need to seek medical attention. But, call your doctor within 24 hours
Call your doctor if you:
- Do not feel well within 5 to 10 minutes after receiving the shock; call your doctor or 9-1-1
- Call your doctor within 24 hours after receiving a shock, even if you feel fine
- Receive therapy from the device two or more times in a 48 hour period
- Receive therapy from the device before your 6 – 8 week follow-up visit
Call your doctor or nursing staff if you have any questions or concerns. You can reach the nursing staff in the Device Clinic from 8 a.m. to 5:30 p.m., Monday through Friday. We prefer that you call during these hours if at all possible. You will be provided the phone number prior to leaving the hospital.
Questions & Answers
What does therapy from the device feel like?
You may or may not be able to tell when your device detects and corrects your heart rhythm. It often depends on the type of therapy you receive from the device:
- Pacing: You may or may not feel the impulses. They are usually painless.
- Cardioversion: The shock may feel like a thump on the chest, but it only lasts for a moment.
- Defibrillation: The shock may feel like a kick in the chest, but it only lasts for a moment. Some patients describe the feeling as a shock from an electrical outlet. Most of the time, you will be awake for the therapy, but you may lose consciousness prior to the shock.
What should I do about my device if I need surgery?
The Device Clinic staff will tell you if programming changes are needed before or after your surgery.
Your pacemaker should be checked within 3 months before your surgery; please schedule an appointment with the Device Clinic.
If you have an ICD, the shock therapies will need to be programmed off during surgery Please contact your doctor’s office so they can make arrangements for this.
How long will my device last?
Pacemakers usually last 8-10 years, depending on how often they are used. When the battery becomes low, the pacemaker will need to be changed.
ICDs and CRT devices last 3 to 6 years.
By keeping your follow-up appointments in the Device Clinic, your health care team can monitor the function of your device and anticipate when it needs to be changed.
