Overview: Device replacement is a surgical procedure to remove and replace an ICD or pacemaker.

Implantable devices like ICDs and pacemakers have finite lifespans, just like any other piece of equipment. Not only do batteries run down or problems develop with some units, sometimes improvements in technology also lead doctors to recommend replacing a device. 

Risks

Device replacement is generally safe. Some rare risks are infection, heavy bleeding, or reaction to the anesthetic. Risks may differ depending on age, health issues, and generator placement. Sometimes you may also need your ICD leads replaced. Your surgeon will let you know ahead of time if this is the case. 

Preparation

Your doctor will give you instructions to follow for the procedure. Pay careful attention to instructions about when to stop eating or drinking, and what you should do about taking your normal medications the day of the procedure. You may need tests such as an electrocardiogram and echocardiogram done before the procedure. 

The procedure

The entire procedure usually takes a few hours. Medical staff may shave your hair around the area where you will have the incision. They will start an IV line to deliver medications as needed. 

The surgeon will make a cut into the skin surrounding your generator (either below your collarbone or in the soft tissue of your abdomen). After the surgeon has access to the generator, he or she will disconnect it from its leads and take it out of your body. The new generator will then be placed in the same pocket as the old generator was. Your old leads will be attached to the generator before the medical staff check the proper functioning of the device. If it works as it should, the surgeon will close up the incision and bandage you.

Recovery

After the procedure, you will be monitored for a few hours. Most people are able to go home then. Sometimes an overnight stay is needed. 

Rest that day (and the next, if needed). You should be able to eat what you normally would after the procedure. You may have some pain after the procedure. Consult your doctor about taking any over-the-counter medications. You will need to care for your wound and may need to take antibiotics for a few days after the procedure. Contact your doctor immediately if you notice heavy bleeding from the incision site, a fever, or other severe symptoms. You will usually have a checkup about a week after the surgery to see how the device is working. Your doctor will monitor the new device regularly. 

HCMA 6/2021