Recovery and everyday activity after ICD implantation

The BHF describes an ICD as a small electrical device that treats dangerously abnormal heart rhythms. It watches the rhythm all the time and can deliver pacing pulses, small shocks (cardioversion) or larger shocks (defibrillation) to restore a normal rhythm.

People may have one after a cardiac arrest or ventricular arrhythmia, because of future risk, or when other treatments have not worked. Underlying causes include previous heart attacks, heart failure, cardiomyopathy and inherited conditions such as Long QT or Brugada syndrome, the BHF says.

The BHF says the procedure typically lasts 1 to 3 hours. A cut of around 5 to 6 centimetres is made on the left chest, wires are guided through a vein to the heart and the device sits between the skin and chest muscle. The wound is closed with special glue or stitches.

For a subcutaneous ICD, the leads run under the skin and the box sits under the armpit. Most people stay overnight, the BHF says, and the device is checked thoroughly before discharge.

The BHF says you can play sports that involve raising your arm, such as golf, though contact sports may need to be avoided. Always get clearance for specific activities from your cardiology or device team.

Wound healing comes first. Follow the written advice you were given on arm movement and lifting in the early weeks, since leads need time to settle. Walking is generally encouraged from the beginning, and some people are referred to cardiac rehabilitation if they have heart failure or recent cardiac events.

• Ask before taking up swimming, weights or racquet sports.

• Avoid activities with a risk of a direct blow to the device.

• Carry the device identity card and show it for hospital scans or procedures.

The BHF says a shock feels like a sudden jolt or thump in the chest or back and may make you jump. Experiences vary: some people feel a mild flutter or notice nothing at all. Shocks cannot harm people touching you.

Follow the instructions your device team gave you. As a rule, one shock after which you feel well should be reported to the device clinic promptly, while repeated shocks, or a shock with chest pain, fainting or breathlessness, needs a 999 call. Your team will confirm the plan that suits you.

BHF driving guidance says that if you have had dangerous rhythms or the ICD has delivered treatment the gap is at least 1 to 6 months, and if you are only at risk it is 1 month. A battery change requires a pause of 1 week. Whether you must tell the DVLA depends on the underlying condition.

Insurers must also be told about the device. If you drive for a living or hold a heavy vehicle licence, stricter rules apply, so ask your team for the current requirements.

The BHF says you will usually have an appointment every 3 to 12 months depending on the type of ICD, and some checks can be done remotely if your device supports it. Clinics review the battery, leads, recorded rhythms and any treatments delivered.

Report new dizziness, fainting, palpitations or wound swelling between visits.

The BHF says it is normal to feel worried about having an ICD fitted. Fear of a shock, especially in public or in bed, is common, and some people avoid activity because of it.

Support options include online communities, cardiac nurses and information booklets, and the BHF emotional wellbeing pages describe anxiety and depression after a heart event as normal. Tell your team or GP if worry limits daily life; psychological therapy is available.