9: Rehab after AICD or LVAD Flashcards
What is an AICD?
Artificial implantable cardiac defibrillator
Why is an AICD implanted?
Detect and correct ventricular fibrillation and bradycardia, correct life threatening arrhythmias
What can an AICD be implanted in conjunction with?
Pacemaker
Where are the leads of an AICD attached, and what do they do?
Ventricles - will sense ventricular fibrillation or other programmed arrhythmias and defibrillate as needed
Will a pt feel the device?
Yes - instructed to notify MD after 2nd defibrillation
What are the goals following ICD placement?
- Avoid complications from bedrest
- Assess activity with vital signs to ensure device is working properly
Why is it important for PT to be involved following ICD placement?
Exercise capacity can be improved with rehab, recommend a support group
When should you initiate mobility following an ICD placement?
The day after surgery or as soon as able
Are there restrictions following ICD placement?
Same as pacemaker - shoulder flexion and ABD to 90 for 4-6 weeks to allow for adherence of leads
What is an important requirement before exercising in the subacute or outpatient phase following ICD placement?
Find out the HR settings where ICD is triggered to fire
What is the recommended HR for exercise following ICD?
Stay 10-20 bmp below the threshold for ICD activation
What are support groups recommended following ICD?
Feelings of fear from initial cardiac arrest or trust in device
What is an effective scale to measure a pt’s self-efficacy for rehab after ICD?
The Self-Efficacy Expectations After Implantable Cardioverter Defibrillator Implantation Scale
Do other tech devices interfere with pacemakers and ICD?
No true data that there is a detrimental interaction
Are modalities a safe option for people with a pacemaker or ICD?
Yes - talk with MD, laser and ultrasound should be at least 6-8” away
What is a LVAD?
Device that will provide the pumping for the pt when their heart cannot pump enough on its own. Can be used as a bridge to transplant or permanent
What are the precautions following LVAD?
Bedrest the day of the surgery, then same as CABG
When should you begin mobility following a LVAD?
The day after surgery
What are restrictions following LVAD?
Possibly UE motion. No pushing or pulling across chest, no lifting more than 5 lbs, no overhead reaching for 4-8 weeks
What should a pt’s blood pressure be following LVAD?
80-100 mmHg
Are pt’s safe to exercise following LVAD?
Yes - must have spare batteries at all times
