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Cardiac Generator Replacement: Care at Home

Your child received a pacemaker or implantable cardioverter defibrillator (ICD) battery or generator replacement. Follow the directions below to care for your child.

Incision Care

  • Leave dressing in place for 48 hours.
  • Steri-Strips® or Dermabond® will dress the incision. This part of the dressing will fall off on its own. Do not peel or pull off.

  • Do not submerge, swim, or soak incision for 3-4 weeks.
  • Showers and bathing can start 2 days after surgery with gauze dressing off. If bathing, keep water below the belly button to ensure the water does not soak the incision.
  • Use clean water to squeeze soapy wash cloth or sponge over incision site.
  • Do not rub incision Steri-Strips® or Dermanond®.
  • Wash area around incision normally.
  • Pat surgical incision dry.
  • At both ends of the incision, suture strings will be trimmed at your clinic incision checkup with your cardiologist or primary care doctor.
  • Itching is normal when healing. Do not scratch. Wearing a T-shirt tucked in or onesie may help to keep hands away from incision.
  • Do not use scented soaps, creams, or ointments until the incision is healed.


  • Let your child ease back to activity as tolerated.
  • Do not bike until the incision is healed.
  • Light contact gym & park play is okay to participate in until incision has healed.
  • If you have an incision under the clavicle for the generator pocket; no backpacks, shoulder purses, or lifting greater than 10 pounds  (1 gallon of milk) for 4 weeks. 
  • Return to school/work 2-3 days after surgery if pain is well controlled with acetaminophen or ibuprofen and activity level has returned to normal.

Home Medications

  • Acetaminophen is used for mild pain and can be given scheduled for the first 24-48 hours.
  • A narcotic can be prescribed only for severe pain. If a narcotic is required for pain control, a stool softener may be needed for a few days to prevent constipation.
  • Rest and relaxation should always be the first line of pain control. Ice packs may be helpful.
  • Scheduled medicines, including anticoagulants, can be restarted in the evening after surgery.

When should I call the cardiologist?

  • New onset of pain or pain not improving with rest and medication.
  • New onset palpitation.
  • Increase swelling, warmth, redness, bruising, or pain around surgery site.
  • Drainage from incision or poor healing.
  • Fever higher than 101°F (38°C) by mouth.
  • Breathing faster or harder.
  • Dizziness or fainting.
  • Pale or bluish color.
  • Unusual cough.
  • Not urinating at least every 8 hours.
  • Repeated vomiting.

Follow Up

  • Generator interrogation transmitter checkups every 3 months from home.
  • Postoperative appointment in 7-10 days.  Incision will be checked and sutures trimmed.


This information is not specific to your child. If you have questions, please contact Children's Heart Clinic at


March 2022

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This page is not specific to your child, but provides general information on the topic above. If you have any questions, please call your clinic. For more reading material about this and other health topics, please call or visit Children's Minnesota Family Resource Center library, or visit

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