Bi-Ventricular ICD Placement

Bi-Ventricular ICD Implantation

Under general anesthesia, your cardiologist will perform the implantation in WakeMed’s electrophysiology laboratory. Your cardiologist will make a small incision on the left side of your chest, near the clavicle. This is a subcutaneous cut, meaning that you are not cut through the muscles or bones, but just under the skin.

A small space is made for the insertion of the pacemaker. Leads that are connected to the pacemaker are run through a vein and placed into your heart using imaging guidance. The leads send a signal to the pacemaker when a corrective shock is needed to get your upper and lower chambers in sync.

The procedure takes about one to two hours, and most patients stay in the hospital overnight for monitoring.

Prior to Surgery

• You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), Clopidogrel (Plavix), warfarin (Coumadin), and other blood thinners.
• Ask your doctor which drugs you should still take on the day of the surgery.
• Discuss any possible bleeding disorders or other medical conditions that you may have with your doctor.
• You will have blood samples taken in case you need a blood transfusion.
• Let your doctor know if you have a cold, flu fever, herpes breakout or other illness prior to surgery. This may require that your reschedule your procedure.
• Do not smoke. This will help you to recover quicker.

On the Day of the Surgery

• You will usually be asked not to drink or eat anything after midnight the night before the surgery.
• Take the drugs your doctor told you to take with a small sip of water.
• Your doctor or nurse will tell you when to arrive at the hospital.

After Surgery

• Most patients will remain in the hospital for at least overnight.
• You will have a dressing over your incision for the next few 24 hours. The incisions are closed with tape called “steri-strips” or glue. You will need to keep this area dry for the next two weeks. Do not allow water to come in contact with the area.
• Do not use any lotions or creams over the site or apply any additional bandages. The strips will be removed by your doctor or nurse at the time of your next office visit.

Recovery: what to expect in the next few weeks

• While you may feel much better after the first week, you need to follow your physician’s orders on recommended activities. Most patients have limitations for the first six weeks and should limit lifting to no more than 10 to 15 pounds and avoid lifting anything above your shoulders.
• Avoid repetitive activities.
• You will be limited to lifting no more than 40 to 50 pounds on the side where the pacemaker was implanted for the rest of your life.
• There are certain restrictions that your physician can explain about being near machinery, generators, magnets, x-ray equipment and cellular phones.
• You will be assigned a registration card to carry that identifies your pacemaker in case of emergency.

Bi-Ventricular ICD Implantation Q&A

What does the implantation involve?

Under general anesthesia, your cardiologist will make a small incision on the left side of your chest, near the clavicle. This is a subcutaneous cut, meaning that you are not cut through the muscles or bones, but just under the skin. A small space is made for the insertion of the pacemaker.

Leads that are connected to the pacemaker are run through a vein and placed into your heart using imaging guidance. The leads send a signal to the pacemaker when a corrective shock is needed to get your upper and lower chambers in sync.

How many incisions are made?

One incision is made in your chest.

How long do I stay in the hospital?

Patients will normally remain in the hospital for an overnight stay.

What is the recovery time?

Most patients feel better after the first week, but patients will have restricted activities for at least six weeks. There are lifting limitations for the rest of your life.