Heart Problems: Living With a Pacemaker or ICD

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Heart Problems: Living With a Pacemaker or ICD

Introduction

A pacemaker or an implantable cardioverter-defibrillator (ICD) helps protect you against dangerous heart rhythms. It's important to know how these devices work and how to keep them working right. Learning a few important facts about pacemakers and ICDs can help you get the best results from your device.

Key points

  • Avoid strong magnetic and electrical fields. These can keep your device from working right.
  • Most office equipment and home appliances are safe to use. Learn which things you should use with caution and which you should stay away from.
  • Be sure that any doctor, dentist, or other health professional you see knows that you have a pacemaker or ICD.
  • Always carry a card in your wallet that tells what kind of device you have. Wear medical alert jewellery that says you have a pacemaker or ICD.
  • Have your pacemaker or ICD checked regularly to make sure it is working right.
 

Pacemakers and ICDs are small electrical devices that help control the timing of your heartbeat.

  • A pacemaker is implanted under the skin of your chest wall. The pacemaker's wires are passed through a vein into the chambers of your heart. The pacemaker sends out mild electrical pulses that keep your heart from beating too slow.
  • An implantable cardioverter-defibrillator (ICD) is implanted under the skin in your chest. A wire threaded through a large vein connects the device to your heart. An ICD is always checking your heart rate and rhythm. If the ICD detects a life-threatening rapid heart rhythm, it tries to slow the rhythm to get it back to normal. If the dangerous rhythm does not stop, the ICD sends an electric shock to the heart to restore a normal rhythm. The device then goes back to its watchful mode. If your heart is beating too slow, the ICD acts as a pacemaker, sending mild electrical pulses to bring your heart rate back up to normal.

Test Your Knowledge

A pacemaker sends out mild electrical pulses that keep your heart from beating too slow.

  • True.
    This answer is correct.

    A pacemaker keeps your heart from beating too slow by sending out mild electrical pulses.

  • False.
    This answer is incorrect.

    A pacemaker keeps your heart from beating too slow by sending out mild electrical pulses.

  •  

If your heart is beating too fast, an ICD sends a strong shock to your heart.

  • True.
    This answer is correct.

    If your heart is beating too fast, an ICD sends a strong shock to your heart. That shock helps your heart return to a normal rhythm.

  • False.
    This answer is incorrect.

    If your heart is beating too fast, an ICD sends a strong shock to your heart. That shock helps your heart return to a normal rhythm.

  •  

Continue to Why?

 

Pacemakers and ICDs run on batteries. To be sure that your device is working right, you will need to have it checked every few months. Your doctor will also make sure your pacemaker settings are right for what your body needs.

You may need to go to your doctor’s office, or you may be able to get the device checked over the phone or the Internet.

In most cases, ICD or pacemaker batteries last 5 to 15 years. When it is time to replace the battery, you will need another surgery, although it will be easier than the surgery you had to place the device. The surgery is easier, because your doctor does not have to replace the leads that go to your heart.

Test Your Knowledge

It's important to have your pacemaker or ICD checked every few months to make sure it is working right.

  • True.
    This answer is correct.

    Pacemakers and ICDs run on batteries. To be sure that your device is working right, you need to have it checked every few months.

  • False.
    This answer is incorrect.

    Pacemakers and ICDs run on batteries. To be sure that your device is working right, you need to have it checked every few months.

  •  

Continue to How?

 

When you have a pacemaker or ICD, it's important to avoid strong magnetic and electrical fields. The lists below show electrical and magnetic sources and how they may affect your pacemaker or ICD. For best results, follow these guidelines. If you have questions, check with your doctor.

Safety guidelines for pacemakers and ICDs

Stay away from:

  • CB or ham radios
  • High-voltage power lines. Stay at least 7.5 m (25 ft) away.
  • Large magnets
  • MRI machines. An MRI uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body.

Use with caution:

  • Cell phones:
    • Do not carry a cell phone in a pocket directly over the pacemaker or ICD.
    • Hold the phone to the ear on the side away from your device.
    • Keep a phone at least 15 cm (6 in.) away from the pacemaker or ICD.
  • MP3 player headphones:
    • Do not keep headphones in a chest pocket. Do not drape headphones over your chest.
  • Keep the following devices at least 30 cm (12 in.) away from the pacemaker or ICD:
    • Arc welders
    • Battery-powered cordless power tools
    • Industrial power generators
    • Magnets
    • Magnetic wands used at airports
    • Stereo speakers
    • Radio transmitters (including those used in toys)

Safe to use:

  • Kitchen and bathroom equipment:
    • Bathroom appliances (electric razors, curling irons, and hair dryers)
    • Kitchen appliances (such as toasters, blenders, electric can openers, and refrigerators)
    • Microwave, gas, and electric ovens
  • Other household items:
    • Electric tools (such as drills and table saws)
    • Lawn and garden equipment (such as mowers and leaf blowers)
    • Heating pads and electric blankets
    • Washing machines and dryers
    • Phones (land-line phones including cordless models)
    • Remote controls
    • TVs, VCRs, CD players, DVD players
  • Office equipment:
    • Computers
    • Copy machines
    • Fax machines
    • Printers

Medical tests and procedures

Most medical tests and procedures will not affect your pacemaker or ICD, except for MRI, which uses strong magnets. To be safe:

  • Let your doctors, dentists, and other health professionals know that you have a pacemaker or ICD before you have any test, procedure, or surgery.
  • Have your dentist talk to your doctor before you have any dental work or surgery.
  • If you need physical therapy, have the therapist contact your doctor before using ultrasound, heat therapy, or electrical stimulation.

Travel

You can travel safely with a cardiac device. But you'll want to be prepared before you go.

  • Ask your doctor what you should do if you receive a shock from your ICD while travelling.
  • Bring your cardiac device identification cards with you. These cards are usually given to people after they first have the device put in. They contain information about the specific type of device that you have, when it was put in, and your doctor's name and phone number.
  • You can safely walk through airport security or anti-theft gates at a normal pace. But do not stand near or lean against them. Before you pass through a metal detector, tell the security guards that you have a pacemaker or ICD, and show them your device identification card. Your pacemaker or ICD may set off a metal detector, but the security archways will not damage the device.
  • If you must be searched, ask the security guard for a hand search. The hand-held security wand contains a strong magnet and should not be used. But if the hand-held wand must be used, it should not be held over your pacemaker or ICD for a long period of time. The security guard should keep the wand at least 30 cm (12 in.) away from your pacemaker or ICD.
  • If your device sets off a security alarm, show your device ID card.

For more tips on travelling safely, see Travel Health.

Letting others know

  • Carry an ICD or pacemaker ID card with you at all times. The card should include manufacturer information and the model number. Your doctor can give you a pacemaker or ICD identification card.
  • Wear medical alert jewellery stating that you have a pacemaker or ICD. You can buy this at most drugstores.

Follow-up care

  • Go to all your appointments with your doctor to make sure your device is working right. Your doctor and/or the device maker will contact you about what to do if your device is recalled.
  • Take all your medicines as prescribed. The medicines work with your pacemaker or ICD to help your heart keep a steady rhythm.

Be safe when exercising

Ask your doctor what sort of activity and intensity is safe for you. If you have a pacemaker, follow these exercise safety tips, such as one that says to stop exercising if you feel dizzy or light-headed.

Pacemaker: Talk with your doctor about exercising with a pacemaker.

ICD: Talk with your doctor about what you need to know before exercising with an ICD.

When to call a doctor

Call your doctor right away if you have symptoms that could mean your device is not working properly, such as:

  • Your heartbeat is very fast or slow, skipping, or fluttering.
  • You feel dizzy, light-headed, or faint.
  • You have shortness of breath that is new or getting worse.

After an ICD shock

Be sure you have a plan for what to do if you get a shock from your ICD. Talk to your doctor if you need to make a plan. In general, your plan depends on how you feel after you get a shock and how many times you get a shock.

After one shock:

  • Call 911 or other emergency services immediately if you feel bad or have symptoms like chest pain.
  • Call your doctor soon if you feel fine right way. Your doctor may want to talk about the shock and schedule a follow-up visit.

After a second shock within 24 hours:

  • Call your doctor immediately, even if you feel fine right away.

Infection near the device

Call your doctor right away if you think you have an infection near your device. Signs of an infection include:

  • Changes in the skin around your device, such as:
    • Swelling.
    • Warmth.
    • Redness.
    • Pain.
  • Unexplained fever.

Test Your Knowledge

It's safe to use a cell phone, but don't keep it in a pocket directly over your pacemaker or ICD.

  • True.
    This answer is correct.

    It's okay to use cell phones when you have a pacemaker or ICD. Just don't carry them in a pocket directly over the device.

  • False.
    This answer is incorrect.

    Cell phones are safe to use when you have a pacemaker or ICD. But you should not carry them in a pocket that is directly over the device.

  •  

You need to carry an ICD or pacemaker ID card with you at all times. The card should include manufacturer information and the model number.

  • True.
    This answer is correct.

    It's important to carry an ICD or pacemaker card with you at all times.

  • False.
    This answer is incorrect.

    It's important to carry an ICD or pacemaker card with you at all times.

  •  

A heartbeat that is very fast or slow, skipping, or fluttering may be a sign that your pacemaker or ICD is not working right.

  • True.
    This answer is correct.

    A heartbeat that is very fast or slow, skipping, or fluttering may be a sign that your pacemaker or ICD is not working right. Call your doctor right away if you have these symptoms.

  • False.
    This answer is incorrect.

    A heartbeat that is very fast or slow, skipping, or fluttering may be a sign that your pacemaker or ICD is not working right. Call your doctor right away if you have these symptoms.

  •  

Continue to Where?

 

Now that you have read this information, you know more about living with a pacemaker or ICD.

If you have questions about this information, print it out and take it with you when you visit your doctor. You may want to make notes on pages where you have questions.

Return to topic:

References

Other Works Consulted

  • Akoum NW, et al. (2008). Pacemaker therapy. In EG Nabel, ed., ACP Medicine, section 1, chap. 7. Hamilton, ON: BC Decker.
  • Baddour LM, et al. (2010). Update on cardiovascular implantable electronic device infections and their management. A scientific statement from the American Heart Association. Circulation, 121(3): 458–477.
  • Lee S, et al. (2009). Clinically significant magnetic interference of implanted cardiac devices by portable headphones. Heart Rhythm, 6(10): 1432–1436.
  • Sears SF, et al. (2005). How to respond to an implantable cardioverter-defibrillator shock. Circulation, 111(23): e380–e382.
  • Swerdlow CD, et al. (2012). Pacemakers and implantable cardioverter-defibrillators. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 1, pp. 745–770. Philadelphia: Saunders.
  • Wilkoff BL, et al. (2008). HRS/EHRA expert consensus on the monitoring of cardiovascular implantable electronic devices (CIEDS): Description of techniques, indications, personnel, frequency and ethical considerations. Heart Rhythm, 5(6): 907–925. Available online: http://www.hrsonline.org/Policy/ClinicalGuidelines/upload/cieds_guidelines.pdf.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Primary Medical Reviewer Brian D. O'Brien, MD - Internal Medicine
Specialist Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Last Revised August 12, 2011

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.