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Implantable Cardiac Monitor (ICM)

What is a ICM? The ICM is a small light-weight device that is inserted just beneath the skin in the upper chest. It will automatically monitor heart rhythms and record them using a handheld activator.

Special considerations before your procedure:

  • If your procedure is scheduled in the morning, do not eat anything after 12 midnight the night
    before If your procedure is scheduled in the afternoon, you may have a light breakfast.
  • Take your routine medications with a sip of water.
  • If you are diabetic and take insulin in the morning, take ½ of your normal dose.
  • If you are are taking a diabetic medication called Glucovance/Glucophage®, stop taking this 
    drug______ days before your procedure unless otherwise directed by your physician.
  • If you are on a blood thinner such as Coumadin®, stop taking this drug ______days before your procedure unless otherwise directed by your physician.
  • If you are taking aspirin and/or Plavix®/Effient®,  continue unless otherwise directed by your physician.
  • If you are taking a diuretic (water pill), do not take it the day of your procedure, unless otherwise directed by your physician.
  • Bring all of your medicines with you in their original containers This includes over-the-counter and herbal medicines.
  • Wear comfortable clothes.

What should I expect when I arrive?

  • You will check in with the receptionist at the Hanson Heart Center within Lakeland Medical Center in St. Joseph and be asked to fill out paperwork.
  • The nurse will take you to the prep area to review your health history and answer your questions. 
  • In the prep area you will sign consents, change into a gown, and have two IVs started. The IVs will allow us to give you fluids and medications as needed. You will also be given an IV antibiotic to prevent infection.
  • You may also need lab tests done before the procedure. 
  • The hair on the area of your chest will be removed with electric clippers.

What happens during the procedure?

  • You will be taken into one of our procedure rooms where you will be placed on the X-ray table. You will be attached to equipment that will monitor your blood pressure, heart rate, and oxygen level. 
  • A nurse is present to give you medications to help you relax and to reduce any pain or discomfort you may experience. 
  • Your physician will numb the area where the device will be inserted. A small incision is made in your upper chest and a “pocket” is made under the skin. This is where the ICM recorder will go. 
  • After the recorder has been placed, it will be tested.
  • The pocket and skin will be closed and a dressing applied.
  • The removal (explant) of the device is similar to insertion (implant). A small incision is made, the device is removed, the incision is closed and a dressing is applied. 

What happens after the procedure?

  • You will be taken to the recovery area and be monitored there for at least one hour.
  • A representative for the device company will instruct you on how to use the ICM's handheld device at home.

When you go home:

  • You will need to have someone drive you home.
  • Go home and rest for the remainder of the day.
  • Instructions concerning your medications, activity, and follow up care will be discussed in greater detail when you are discharged home.