START HERE
Your transvenous defibrillator (icd) checklist
Keep this page with your medication plan and discharge instructions.
Before you arrive
- Read the “Getting ready” section. Use the medicine and food-and-drink plans recorded there; blank lines must be completed by your team before you use them.
- Complete the tests in your appointment instructions. Bring your current medicine list, identification and insurance information.
- Arrange an adult to drive you home and stay with you the first night.
Procedure date / arrival time:
Facility / check-in location:
Before you leave the facility
- Make sure you have your medication restart plan, wound-care and activity instructions, written driving-clearance plan, and booked follow-up details. Read the shock action plan before going home.
- Keep the “Your recovery” and “When to get help” sections available at home. Call 911 for the emergency symptoms listed there.
Follow-up appointment or timeframe / booking instructions:
Practice phone: ____________________
After-hours number / route: ____________________
Keep the instructions together
Your personalized medication, anesthesia and discharge instructions take priority over general template wording. The team should record the current documents below and resolve any conflicting instructions before you leave.
Medication / anesthesia plan title and date:
Discharge instructions date:
UNDERSTANDING YOUR PROCEDURE
Your transvenous
defibrillator (ICD)
Before and after a new Transvenous ICD implant
What the ICD does
An implantable cardioverter-defibrillator (ICD) monitors the heart and treats dangerously fast rhythms from its lower chambers. A battery unit usually sits under the skin near the collarbone. One or more leads pass through a vein into the heart; this is called transvenous implantation.
Depending on its programming and your rhythm, the ICD may use small rapid pacing signals (ATP) or a shock. It can also provide pacing for a slow heartbeat when needed. A shock can be painful but brief. The ICD does not replace your medicines or prevent every cardiac emergency.
On the day
The implant area is numbed. Sedation or general anesthesia is used according to your anesthesia plan. The leads are placed using imaging, connected to the generator and tested. Your team may test shock function when appropriate. The incision is closed and covered, and antibiotics are given around the procedure.
Before discharge, the team checks the device and wound and usually obtains a chest X-ray. You may go home the same day or stay overnight. This guide covers a new transvenous ICD, not an S-ICD, a CRT-D-specific implant, lead removal or generator-only replacement.
Benefits and risks
An ICD can reduce the risk of sudden death from dangerous ventricular rhythms; it does not cure the underlying heart disease. Risks include bleeding, infection, lead movement, a collapsed lung, heart perforation or fluid around the heart, blood-vessel injury, unwanted shocks, device problems and a need for another procedure. Serious complications, including death, are possible.
Getting ready
Medicines and fasting
Use the written plan below. Blood thinner and antiplatelet instructions depend on your medication, kidney function, bleeding risk and any recent coronary stent. Do not copy an AF ablation hold plan or stop these medicines on your own. A missing or conflicting procedure-day plan needs clarification before you change a dose.
Blood thinner / antiplatelet plan
Food and drink plan
SGLT2 medicines
GLP-1 medicines
Additional preparation
- Bring allergy information with the items on your “Start here” checklist.
- Report fever, an active infection, or broken/infected skin near the planned implant before coming for the procedure.
- Wear a loose, front-opening shirt. Do not shave the implant area yourself.
Recovering at home
What is usually expected
Mild soreness, bruising and a small stable swelling around the incision can occur. You may feel the device under the skin. These should improve, not become increasingly painful, red or swollen. Follow the discharge medication list; an ICD by itself does not mean you must start a blood thinner.
Wound care and movement
Walk gently and use your arm for comfortable daily activities. Avoid pressure or rubbing over the device. Use the wound-care plan below for your dressing and shower timing. Do not soak the incision until it has healed.
Driving clearance date OR review date / responsible team:
Return-to-work date / restrictions if needed:
Any handwritten exceptions must be completed by the implant team. Never drive while dizzy, faint, or impaired by sedating medicine. Commercial driving and a history of fainting require a separate plan.
Follow-up and remote monitoring
Wound / device appointments or timeframes / booking instructions:
For monitor setup or connection problems, use the manufacturer support number supplied with the monitor. For symptoms, use the emergency and same-day warning signs in this guide. Keep your device ID card with you and show it to medical and dental staff.
Everyday life & when to get help
If you receive a shock
Stop what you are doing and sit or lie down safely.
- Call 911 now for more than one shock in a row, or a shock with chest pain, trouble breathing, fainting, ongoing dizziness or feeling unwell. Do not drive yourself.
- One shock and feeling completely well: contact the device clinic promptly the same day, using the after-hours route if needed. Record the time, symptoms and what you were doing. Send a remote transmission if your device team instructs you to; do not assume it has been seen. If you cannot reach the team promptly, seek urgent medical assessment.
- After any shock, do not drive again until the device team reassesses and clears you.
If someone collapses and is unresponsive and not breathing normally, call 911, start CPR and use an AED as instructed. Do not wait for the implanted device to treat them.
Phones, magnets and medical tests
- Keep phones, magnetic earbuds and other small magnetic electronics at least 6 inches (15 cm) from the ICD. Use the opposite ear and do not store a phone in a chest pocket over the device.
- Do not place magnets or magnetic therapy products over the implant; a magnet can stop the ICD from delivering a needed shock. Strong industrial magnets and certain equipment need device-specific advice.
- Most ordinary household appliances, including microwaves in good working order, can be used normally.
- Tell the imaging team about your ICD before any MRI. Many patients can have MRI under a special protocol, but the complete device-and-lead system must be checked and the device may need programming. Do not assume it is safe without that check.
Call 911
- Severe or sudden trouble breathing, severe chest pain, fainting, or stroke symptoms such as facial droop, arm weakness or trouble speaking.
- Heavy bleeding that does not stop with firm pressure, or rapidly expanding painful swelling with weakness or faintness.
Do not drive yourself. The remote monitor is not an emergency alert system.
Contact the device clinic the same day
- Beeping or vibration from your device, even if you feel well; it may be an alert that needs prompt checking.
- Fever or chills; increasing redness, warmth, pain or swelling; drainage; wound opening; or visible device/lead material.
- New swelling of the arm on the implant side, persistent hiccups or twitching, or return of dizziness or near-fainting.
- Growing swelling or bleeding around the implant, even if you otherwise feel well.
Use the clinic’s after-hours contact route if needed. If you cannot reach the team and symptoms are worsening, seek urgent assessment; use 911 for severe symptoms.
Tell the device team if fear of shocks, anxiety or low mood is interfering with sleep or daily life. Support and treatment are available.
Follow your personalized medication and recovery plan. This guide supports, but does not replace, the consent discussion or your implant team’s instructions.