Getting an ICD Implanted: What to Expect

You will need surgery to have the ICD placed under the skin through a small cut (incision). The surgery takes a few hours. You may need to stay in the hospital overnight, though many people go home the same day.

There are different types of ICDs. Some ICDs have wires that go through the blood vessels and into the heart. Other ICDs (called “subcutaneous” or “extra vascular”) have leads that are placed outside the heart. If you choose to get an ICD, you and your health care team will talk about which type is best for your condition, as well as how it will be placed.

There will be a bump the size of a small bar of soap under your skin and a visible scar. Sometimes this takes some getting used to.

More Information: Living Well With an ICD 

It’s important to follow the specific instructions you are given by your care team. 

Here is some basic information for what you might need to think or ask about before and after having your ICD placed.

Before the procedure

• Review all of the medications you take, including over-the-counter medications, with your health care team. Ask if there are any you need to stop briefly.
• Arrange for someone you trust to drive you home – some people can go home the same day, but others may stay overnight for closer monitoring. You may also need someone to stay with you at home. 
• Leave any jewelry or valuables at home.
• Follow directions about not eating or drinking anything for a period of time before the procedure.
• Bring a button-down shirt to change into to avoid having to reach or pull clothing over your head.

In the first few days or weeks after the procedure

• You may feel sore and have some bruising in the area where the ICD was placed.
• Be sure to follow the instructions you are given and keep your incision dry for as long as your doctor advises (usually 5-7 days). Report any signs of redness, swelling, or infection to your health care team.
• You should be able to return to your usual activities after 6-8 weeks of recovery, depending on your type of ICD. During this period, try not to overdo it. You may need to limit or avoid:
• Lifting anything heavier than 10-15 pounds (think of a gallon of milk or a bag of potatoes)
• Raising your arm above your shoulder (for example, you’ll need to carefully get dressed, especially when pulling a shirt on over your head and perhaps avoid golf, tennis and other activities for a period of time)
• Pushing, pulling or sudden twisting motions or other strenuous activities (for example, vacuuming)
• Wearing anything that rubs against the incision
• Driving, based on what your doctor says
• You can bathe and shower as usual. 

After having your ICD placed

It can be helpful to know what you will need to think about after having an ICD placed and over the longer term living with the device.

• Talk with your care team about returning to your daily activities and if there is anything you can’t do for a period of time. For example, ask about when you can:
  • Return to work.
  • Resume exercise, especially to start to use your upper arm so it doesn’t get stiff. Also ask about any high-contact sports.
  • Drive – a person with an ICD cannot drive a commercial vehicle/hold a commercial driver’s license
  • Have sex.
  • If you need to avoid or distance yourself from electrical signals from other devices. For example, cellphones, wireless chargers, headphones, metal detectors, medical imaging equipment, heavy machinery, chainsaws or welding.
• Always carry your ICD identification card with you. It has important information about your device. Make a copy and take a picture of it to keep on your phone too.
• Make a plan together with your heart doctor for:
  • Regular ICD checks and monitoring 
  • What you should do if your ICD starts making noise
  • What steps to take if you get an electric shock from your ICD
• Call your doctor if you:
  • Get shocked
  • Feel dizziness or faint
  • Have worsening shortness of breath
  • Have chest pain
  • Notice any redness, swelling or bleeding near where the ICD was placed
• There is an emotional side to living with an ICD. Many patients say this is not often talked about. It may take some time to adjust to your ICD. Some people may not like how it feels, or they may worry about being shocked. Some people find it harder than expected to see their scar. Others say it is reassuring to have an ICD. Be sure to find support and be aware of your feelings.
• Your needs and wishes around your ICD may change over time. For example, if you end up facing end-of-life decisions due to cancer or other reason, talk with your care team. Some people wish to turn off their ICD to avoid unwanted shocks. This is even recommended when a person is close to dying of another cause. It is possible to keep the pacemaker function turned on. Talk about this with your health care team.