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Implantable Cardioverter Defibrillator (ICD)

Your Cardiologist has recommended you have an ICD inserted, your ICD acts as a pacemaker but also has the ability to deliver shock to your heart to terminate life threatening heart rhythms with a brief period of rapid pacing or a shock.
An ICD is required when there is a disturbance in the hearts ability to transmit electrical impulses. This results in the heart beating too slow or irregularly. The effect of the heart rhythm disturbance could possibly cause symptoms such as dizziness, fatigue or generally feeling unwell.
The ICD acts as a pacemaker but also has the ability to deliver a shock to your heart to terminate life threatening heart rhythms.
The Anaesthetist will give you a general anaesthetic for the entire procedure so any shocks delivered during testing of the device will not be felt.

Your Appointment:

  • Following your consult or referral your Cardiologist will schedule a booking at the earliest time available.
  • You will be sent a letter of confirmation from The Sutherland Heart Clinic or Sutherland Hospital detailing your instructions.
  • You will be required to phone the Clinic the day before your procedure between 10am and 3pm for your admission time and any further instructions regarding fasting and medications. For Monday procedures call the prior Friday.
  • Please inform the secretary if you require accommodation (especially if you have to travel) or need an interpreter.

Preparation:

Fasting:

Depending on your Doctors advice, you will be required to fast (that is no food) for at least 6 hours prior to your procedure. Clear fluid can be taken up to 3 hours prior to your procedure, this includes black tea or coffee, it does not include milk or liquids with substances floating in it e.g. orange juice pulp.

Hygiene:

No special requirements – shower or bath as per usual.

Medications

All usual medications (including Aspirin, Clopidogrel -Plavix or Iscover)) must be taken on day of procedure with a sip of water with the exception of the below medications:

Warfarin

If you take the medication Warfarin you will need to consult with the cardiologist performing the procedure who will advise you if you need to stop taking your Warfarin, and if so how soon before your procedure. You may also be advised to take a substitute anticoagulant (blood thinner) and the arrangements for this. It is very important that you do not stop taking your Warfarin without medical advice.

Insulin

If you are prescribed insulin we suggest you eat a light early breakfast and take half your regular insulin dose. Remind the booking staff that you are on insulin and we will attempt to schedule your procedure as early as possible.

Diabetic Patients

 

 

 

 

  • If Insulin Controlled:
  • You should have an early morning breakfast (ie 0600 hours) and half (1/2) regular insulin (please bring in insulin).


  • If Tablet Controlled:
  • You should withhold your oral agent on the morning of the procedure.

     

    (Metformin - and its other names: Diabex, Diaformin, GenRX, Glucohexal, Glucomet, Glucophage and Meformin BC - should be ceased 48 hours prior to the morning of the procedure).

     

    You may have a light early breakfast if not fasting from midnight.


  • If Diet Controlled:

    You may have a light early breakfast if not fasting from midnight.

     

    If Changing Your Medication

    Please discuss the changes with your cardiologist.

 

 

What to bring with you:

  • Health insurance details
  • Medicare card
  • Referral letter /s
  • Xrays and pathology results
  • A list of your current medications
  • Reading material
  • An overnight bag and toiletries

On The Day :

Privately Insured Patients
All patients coming to Sutherland Heart Clinic as private patients come directly to the clinic for their admission.
Public Hospital Patients
All patients coming to Sutherland Heart Clinic as public patients must first go to the Public Admissions office of The Sutherland Hospital before being directed to the Sutherland Heart Clinic.

 

On a typical day events will occur in the following stages:

Stage 1. Check in: When you arrive at the clinic reception you will be asked to fill in some admission forms.

Stage 2. Initial preparations: Nursing staff will call you in and show you where to change into a hospital gown and where to store your belongings.
Stage 3. Pre Op: A detailed nursing and medical admission will be taken. An electrocardiogram (ECG) will be performed and an intravenous needle (IV) will be inserted into your arm for fluids and medications. You will be required to read your consent form and sign it with your cardiologist.

Stage 4. The procedure: You will be taken into one of the procedure rooms on your bed. Members of the team will ask you to lie down on the table while they carry out various preparations such as attaching monitoring cables to your chest and preparing equipment. You will then be covered with sterile surgical drapes. We will respect your privacy at all times. A number of procedures performed at the clinic require only local anaesthetic whereas others require a general anaesthetic. The nursing and medical staff will inform you of your level of anaesthetic prior to the procedure.

Stage 5. Clean up and transfer to Recovery: Once the procedure is completed the surgical drapes will be removed and the insertion site cleaned. You will then be transferred to the recovery unit.

Stage 6. Recovery: After arriving in recovery the staff will attach you to our cardiac monitors and assess your vital signs. If you are a day only patient you will undertake a controlled recovery and mobilisation process. If you are staying in hospital overnight you will be in the recovery area until you are stable and transferred for ongoing care.

DAY STAY PATIENTS SHOULD EXPECT TO BE AT THE CLINIC FOR AT LEAST 6 – 8 HOURS FROM TIME OF ADMISSION TO TIME OF DISCHARGE

Stage 7. Discharge: Once you are ready for discharge the nursing staff will ask you to get changed and will then take you through the discharge process. You will have your intravenous needle removed from your arm, your X-rays will be returned and the nursing staff will give you your discharge instructions. It is good if a relative/carer/ custodian can be with you at this time to hear these instructions.

IT IS ADVISABLE THAT ALL DAY STAY PATIENTS HAVE SOMEONE STAY WITH THEM OVERNIGHT ON THE DAY OF THEIR DISCHARGE. PLEASE ENSURE YOU TAKE ALL YOUR BELONGINGS WITH YOU AND LEAVE THE LOCKER KEY IN THE DOOR OF THE LOCKER ON YOUR DEPARTURE.

Procedure Time

Takes approximately 1- 2 hours.

Length of Stay

You will be admitted to the Clinic on the morning of your procedure. Following your procedure you will be required to stay overnight as you will need to return to the laboratory to have your newly inserted device tested.

Visitors

Your immediate family or carers can see you briefly in recovery after the procedure and when you are up and walking around. The staff will advise you of the time your family can collect you.

Driving

You are not  permitted to drive a car, sign important documents, work etc for at least 24 hours following a General Anaesthetic. You will need to discuss with your referring cardiologist or the cardiologist performing the procedure when you can drive. So please make alternative transport arrangements.

Results of your procedure

Your Doctor will inform you of the results of your procedure and the appropriate treatment / management prior to your discharge.

Security

Secure lockers are provided for your belongings, however please do not bring large amounts of cash or valuables with you on the day.

Parking  

For patients and Visitors to Sutherland Heart Clinic an underground parking station is located off Barker Street which has a maximum of $16 per day..

Relatives and Friends ..

Are welcome to wait at the Clinic but cannot go in with the patient once they are called for their procedure. Our staff are happy to answer any of your enquiries and will give you an estimated discharge time.

Please note that Sutherland Heart Clinic is part of a tertiary referral centre and at times we are required to undertake emergency procedures as a priority. This may at times lengthen your stay at the clinic.

Discharge

Following the procedure your Cardiologist and the technician will speak to you and provide you with detailed information on your defibrillator and instructions on taking care of your wound. In addition you will also be given a course of antibiotics and some tablets to take for any discomfort.

Health Insurance Coverage

Sutherland Heart Clinic has contracts with all private health insurance funds. Sutherland Heart Clinic is a NO GAP facility. Please confirm details with us and your fund prior to your procedure. If you have an excess or co-payment on your health insurance cover then you may incur some out of pocket expenses.

Medical Research

Sutherland Heart Clinic, like most specialist centres, undertakes ongoing research projects. Research projects undergo stringent screening from a panel of scientists, doctors and members of the community who verify that methods used are sound, safe and ethical. You may be asked if you would like to participate in a current research project while you are at the clinic.
Participation is entirely voluntary. If you think you might be interested you will be given a full explanation and information about what is to be tested, if any
alternatives are available and any risks and / or benefits you may experience. Written consent is a participation requirement of the study but is by no means a contractual arrangement as you can withdraw at any time.

What You can Reasonably Expect while in our Care:

You are entitled to be treated with care and dignity. You are entitled to a
clear explanation by your doctor of:

  • Your condition, problem or disease.
  • Any planned treatment or investigation.
  • Any alternative procedures available.
  • Possible side effects, the chances of success and any serious risks involved.

By presenting yourself to the Clinic you have implied general consent for treatment. However for specific procedures and for patients who may be having a general anaesthetic you will be required to give written consent after suitable information is given. You may withdraw your consent and refuse further treatment at any time. You have the right to know the identity and professional status of the individuals providing service to you. Staff employed by the Clinic are required to wear identification badges. You have the right to privacy when undergoing any treatment or procedure. Sutherland Heart Clinic respects and upholds patient rights to privacy protection under the National Privacy Principles contained in the Privacy Act 1988. The National Privacy Principles apply to the Clinic from their introduction on December 21st 2001.

The Clinic has in place a Personal Information and Privacy Policy which outlines how the Clinic:

  • Collects your health information
  • What we do with it
  • The quality and security of your data
  • Your rights to access and correct information

You may access our Privacy Policy at anytime whilst at the Clinic.
You should expect the clinic environment to be safe and comfortable.

Your Responsibilities:

Try to be well informed about your condition and treatment. Please ask questions if you do not understand something. You have the responsibility to provide, to the best of your knowledge, accurate and complete information about your present condition, past illnesses, hospitalisations, medications and any other matters relating to your health.
It is in your interests to comply with the prescribed treatment or care and the pre and post operative instructions. You will be responsible for your own actions if you do not follow the prescribed instructions or refuse medical treatment. You should attend the recommended follow up appointments, or advise those concerned if this is not possible.
It is your responsibility to provide accurate details of your Medicare information and/or private health insurance. Please show consideration for other patients, staff and property of the Clinic. By complying with your responsibilities you are helping us help you.

If a Problem Arises:

Please tell your Doctor or the Nurses if a problem arises, in most cases they
will be able to help you. Should you not receive a satisfactory outcome you should request to see the Director of Nursing for clinical issues or the Office Manager for
administrative issues. They will investigate your complaint and advise you of the outcome or of options if further action is required.
If you wish to take your complaint further you may utilize the following options:

Private Health Insurance Ombudsman
Suite 1201, Level 12, St Martin’s Tower
31 Market Street
SYDNEY NSW 2000
Telephone: (02) 9261 5855 Toll Free: 1800 640 695

NSW Health Care Complaints Commission
Level 13, 323 Castlereagh Street
SYDNEY NSW 2000
Telephone: (02) 9219 7444

Director General NSW Health
73 Miller Street
NORTH SYDNEY NSW 2060
Telephone: (02) 9391 9000