How long do you stay in the hospital after a defibrillator

An implantable cardioverter-defibrillator (ICD) is a device that detects any life-threatening, rapid heartbeat. This abnormal heartbeat is called an arrhythmia. If it occurs, the ICD quickly sends an electrical shock to the heart. The shock changes the rhythm back to normal. This is called defibrillation.

An implantable cardioverter-defibrillator (ICD) is a device designed to quickly detect a life-threatening, rapid heartbeat coming from the bottom chamber of the heart. It converts the abnormal rhythm back to normal by delivering an electrical shock to the heart.

An ICD is made of these parts:

The pulse generator is about the size of a large pocket watch. It contains a battery and electrical circuits that read the electrical activity of your heart.
The electrodes are wires, also called leads, that go through your veins to your heart. They connect your heart to the rest of the device. Your ICD may have 1, 2, or 3 electrodes.
Most ICDs have a built-in pacemaker. Your heart may need pacing if it is beating too slowly or too fast, or if you have had a shock from the ICD.
There is a special kind of ICD called a subcutaneous ICD. This device has a lead that is placed in the tissue to the left of the breastbone rather than in the heart. This type of ICD cannot also be a pacemaker.

A cardiologist or surgeon most often will insert your ICD when you are awake. The area of your chest wall below your collarbone will be numbed with anesthesia, so you will not feel pain. The surgeon will make an incision (cut) through your skin and create space under your skin and muscle for the ICD generator. In most cases, this space is made near your left shoulder.

The surgeon will place the electrode into a vein, then into your heart. This is done using a special x-ray to see inside your chest. Then the surgeon will connect the electrodes to the pulse generator and pacemaker.

The procedure most often takes 2 to 3 hours.

Some people with this condition will have a special device that combines a defibrillator and biventricular pacemaker placed. The pacemaker device helps the heart to beat in a more coordinated fashion.

An ICD is placed in people who are at high risk of sudden cardiac death from an abnormal heart rhythm that is life threatening. These include ventricular tachycardia (VT) or ventricular fibrillation (VF).

Reasons you may be at high risk are:

You have had episodes of one of these abnormal heart rhythms.
Your heart is weakened, too large, and does not pump blood very well. This may be from earlier heart attacks, heart failure, or cardiomyopathy (diseased heart muscle).
You have a type of congenital (present at birth) heart problem or genetic health condition.

Risks for any surgery are:

Possible risks for this surgery are:

Wound infection
Injury to your heart or lungs
Dangerous heart arrhythmias

An ICD sometimes delivers shocks to your heart when you DO NOT need them. Even though a shock lasts a very short time, you can feel it in most cases.

This and other ICD problems can sometimes be prevented by changing how your ICD is programmed. It can also be set to sound an alert if there is a problem. The doctor who manages your ICD care can program your device.

Always tell your health care provider what drugs you are taking, even drugs or herbs you bought without a prescription.

The day before your surgery:

Let your provider know about any cold, flu, fever, herpes breakout, or other illness you might have.
Shower and shampoo well. You may be asked to wash your whole body below your neck with a special soap.
You may also be asked to take an antibiotic, to guard against infection.

On the day of the surgery:

You will usually be asked not to drink or eat anything after midnight the night before your surgery. This includes chewing gum and breath mints. Rinse your mouth with water if it feels dry, but be careful not to swallow.
Take the drugs you have been told to take with just a small sip of water.

You will be told when to arrive at the hospital.

Most people who have an ICD implanted are able to go home from the hospital in 1 day. Most quickly return to their normal activity level. Full recovery takes about 4 to 6 weeks.

Ask your provider how much you can use the arm on the side of your body where the ICD was placed. You may be advised not to lift anything heavier than 10 to 15 pounds (4.5 to 6.75 kilograms) and to avoid pushing, pulling, or twisting your arm for 2 to 3 weeks. You may also be told not to raise your arm above your shoulder for several weeks.

When you leave the hospital, you will be given a card to keep in your wallet. This card lists the details of your ICD and has contact information for emergencies. You should always carry this wallet card with you.

You will need regular checkups so your ICD can be monitored. The provider will check to see if:

The device is properly sensing your heartbeat
How many shocks have been delivered
How much power is left in the batteries.

Your ICD will constantly monitor your heartbeats to make sure they are steady. It will deliver a shock to the heart when it senses a life-threatening rhythm. Most of these devices can also work as a pacemaker.

Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2018:72(14):e91-e220. PMID: 29097296 pubmed.ncbi.nlm.nih.gov/29097296/.

Epstein AE, DiMarco JP, Ellenbogen KA, et al. 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2013;61(3):e6-e75. PMID: 23265327 pubmed.ncbi.nlm.nih.gov/23265327/.

Miller JM, Tomaselli GF, Zipes DP. Therapy for cardiac arrhythmias. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 36.

Pfaff JA, Gerhardt RT. Assessment of implantable devices. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 13.

Swerdlow CD, Wang PJ, Zipes DP. Pacemakers and implantable cardioverter-defibrillators. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 41.

Last reviewed on: 6/25/2020

Reviewed by: Micaela Iantorno, MD MSc FAHA RPVI, Interventional Cardiologist at Mary Washington Hospital Center, Fredericksburg, VA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Because every patient is different, it’s hard to say with certainty what your recovery time will be. In general, you should be able to return home the day after your implant procedure. Full recovery from the procedure normally takes about 4 to 6 weeks.

Your doctor will provide you with a complete set of instructions to follow once your procedure is completed. Always consult your doctor for specific information or to ask any additional questions you might have. You‘ll also receive a patient identification card, which alerts medical and security professionals that you have an implanted medical device.

Though different people recover at different paces, the following timeline can give you an idea of what to expect and when:

Day of your implant

You will be given a course of antibiotics to take before and after the implantation procedure to minimize the risk of infection. Be sure to finish taking the complete course of antibiotics, even if you feel better.

1 day later

As the wound can feel quite bruised and sore, especially for the first day or two, you should take analgesics (painkillers) as needed but don’t exceed the recommended daily dose.
Talk to your nurse about any pain you might be experiencing

1 week later

Keep the wound clean and dry until it has fully healed.
It’s fine to have a bath or shower after the first 3 or 4 days. Your nurse can provide you with a protective dressing so that you can bathe without getting the wound wet.
Report any problems you have with the wound to your nurse.

1 month later

A few weeks after your EMBLEM MRI S-ICD System has been implanted, you will have an initial appointment with your doctor to make sure your incision is healing well and your device is working correctly. This will be followed by regular visits with your doctor every 3 to 6 months.

Below are some general guidelines to help you after your procedure. They should not replace any instructions given to you by your physician.

First 2 weeks after your procedure

Try to avoid arm movements that could create pressure on the wound
Avoid exercise (although you do not need to stay seated or lying down)
Avoid lifting heavy objects (this will slow healing and increase the chance of infection)

First 4 to 6 weeks after your procedure

When your wounds have healed, you can move freely
Slowly build up your level of exercise
Avoid contact sports (e.g. football, rugby). If you want to drive, check to see if there are any restrictions
Talk with your doctor before taking a long-distance trip
Once you have fully recovered from the implant procedure, there should be little change to your normal daily life.

Ongoing

Your doctor will schedule regular visits with you every 3 to 6 months to see how you are doing and to check your EMBLEM MRI S-ICD System.  During these routine check-ups, your doctor may adjust the settings of your EMBLEM MRI S-ICD System using a wireless programmer.
If your EMBLEM MRI S-ICD System delivers therapy (an electric shock), you should notify your doctor. Some people experience the therapy as painful or uncomfortable. While it might be startling, it means that the EMBLEM MRI S-ICD System may have detected a dangerously fast heart rhythm and delivered the defibrillation therapy you needed to reset your heart’s electrical system.

Meet real S-ICD System patients as they share their stories and personal journeys.

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