Post ICD implant pain

I just had my first ICD put in a little over two weeks ago. In general I feel SO much better than I have in the past 2 1/2 years (diagnosis is heart failure) but I've got pain up at my collarbone where the leads are going into the carotid artery. I expected pain from the muslce trauma where they inplanted the ICD but not where the leads are. It feels tight there and like they're "pulling", even if I'm not moving around.  I'm a leg amputee and walk with forarm crutches, so use my pec muscles every time I step with the crutches.  I stayed off them completely the first 14 days to give the incision and pecs some time to heal.

Is it normal to have this much pain up where the leads are going into that artery? I dont know if I should contact the doctor or wait it out a couple weeks longer and see if it starts to subside.

I don't know if I should stay off the crutches more or use them more and see if things "losen up".



by Jimmy Dinfla - 2019-02-03 04:53:27

You will be sore for awhile.  Rather than worrying, recommend seeing your doctor.

Pain on use of crutch after PM insertion

by Selwyn - 2019-02-03 09:09:55

I think the most likely scenario is that as you use the crutch, the soft tissues are moving headward and the pacemaker is pushing into the collar bone. 

The way to tell would be to be full weight bearing on the crutches and get someone to have a feel. Is the top edge of the ICD in contact with the collar bone. If so, it is probable this will need to be repositioned for your personal requirements which may not have been allowed for.

Leads are placed in veins to my knowledge.

It takes a good 6 weeks for the 'pocket around the ICD to form- I think I would continue if possible for that time and then see how it feels.


thank you

by RedRocksGirl - 2019-02-03 17:10:21

Thanks for your responses!  My ICD was placed just below my arm pit, so its not anywhere near my collar bone. (I can actually feel the edge of it along my left side and can push it easily an inch or so towards my midline. It moves quite a bit.). I went to see the EP a week after surgery becasue I thought it had "dropped" down there, but he said it was put there becasue I'm so small and it would be less visible. They said the place along my collar bone that is painful is actually where the leads are anchored going into the carotid artery. I can feel with my fingers where the leads are coming up my chest from the incision and into the artery. So weird. 

I think it makes sense what you said, Robin1, about needing to move, keep the mobilty in that area so it doesn't end up being scar tissue that limits the mobility/range of motion there.  I wish they had prescribed a physical therapist to work with right off the bat so I'm moving it enough to not scar too tight but also not move it too much to impede healing. I talked to 2 EPs and one of their PAs about crutch use involving the pec muscles that they were going to be cutting into and felt like none of them were listening to me at all.  Super frustrating!

Although I'm on crutches, I'm super active and work out all the time.  I did the 1 mile, straight up the mountain 2,744 railroad tie stair steps up the Manitou Incline a couple summers ago and am hoping to do it again this or next summer depending on how quickly I can get my arms back in shape.

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