What is pacemaker or icd replacement?

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Pacemaker or implantable cardioverter-defibrillator (ICD) replacement: Overview

Pacemakers and implantable cardioverter-defibrillators (ICDs) are battery-powered devices that are implanted in the body to treat heart rhythm problems. Your device is placed beneath the skin of your chest. One to three wires (called leads) connect the device to your heart. When the battery runs down, or if the device isn't working well, you may choose to have the device replaced.

The leads can be left in place and reconnected to your new device. But if your doctor thinks you need new leads, the doctor can replace them at the same time.

You will get medicine before the procedure. This helps you relax and helps prevent pain. You may also get an antibiotic to help prevent infection. The doctor will make a cut in the skin next to your device. The doctor will remove the device and put a new one in its place. The doctor will then attach the leads to the device. The cut will be closed with stitches, tape, or a special glue.

The procedure usually takes about an hour. You may go home the same day. If the leads were replaced, you may need to spend the night in the hospital.

How can you care for yourself after pacemaker or implantable cardioverter-defibrillator (ICD) replacement?


  • Rest when you feel tired.
  • Be active. Walking is a good choice.
  • Avoid activities that strain your chest or upper arm muscles until your doctor says it's okay. This may be for a week or two. These activities include pushing a lawn mower, mopping floors, swimming, and swinging a golf club.
  • Do not raise your arm (the one on the side of your body where the device is located) above your shoulder until your doctor says it's okay. This may be for one week.
  • Allow your body to heal. Don't move quickly or lift anything heavy until you are feeling better.
  • Ask your doctor when it is okay for you to have sex.


  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.


  • Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Be safe with medicines. Read and follow all instructions on the label.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.

Incision care

  • If you have strips of tape on the cut (incision) the doctor made, leave the tape on for a week or until it falls off.
  • You may shower 24 to 48 hours after surgery. Pat the incision dry. Don't swim or take a bath for the first 2 weeks, or until your doctor tells you it is okay.
  • You will have a dressing over the incision. A dressing helps the incision heal and protects it. Your doctor will tell you how to take care of this.

Other instructions

  • Keep a medical ID card with you at all times that says you have a heart device. You'll get an updated one with information about your new device. The card should include the manufacturer and model information.
  • Wear medical alert jewelry stating that you have the device. You can buy this at most drugstores.
  • Be sure you know what to do if you hear an alarm or feel a vibration from your device. Your doctor can give you instructions.
  • Check your pulse regularly if your doctor recommends it.
  • Have your device checked as often as your doctor recommends. In some cases, this may be done online. Your doctor will give you instructions about how to do this.

How do you prepare for pacemaker or ICD replacement?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

After pacemaker or implantable cardioverter-defibrillator (ICD) replacement: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have trouble breathing.

Call your doctor now or seek immediate medical care if:

  • You receive a shock from your ICD.
  • You are dizzy or lightheaded, or you feel like you may faint.
  • You have pain that does not get better after you take pain medicine.
  • You hear an alarm or feel a vibration from your heart device that means to call your doctor.
  • You have loose stitches, or your incision comes open.
  • Bright red blood has soaked through the bandage over your incision.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You have any problems with your device.

After pacemaker or implantable cardioverter-defibrillator (ICD) replacement: Overview

Pacemaker or ICD replacement is surgery to put a new heart device in your chest. The battery in your new device is fully charged. Your doctor may have also replaced the wires (leads) from the device to your heart, if needed.

Your chest may be sore where the doctor made the cut (incision) and put in the device. You also may have a bruise and mild swelling. These symptoms usually get better in 1 to 2 weeks. You may feel a hard ridge along the incision. This usually gets softer in the months after surgery. You may be able to see or feel the outline of the device under your skin.

You may be able to go back to work or your usual routine within 1 week after surgery. It may take as long as 2 weeks if your leads were also replaced.

What happens on the day of your pacemaker or ICD replacement?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. You may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
  • The surgery may take about 1 hour. It may take longer if the leads are replaced.

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The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.