How Will an Implantable Cardioverter Defibrillator Affect My Lifestyle?

The low-energy electrical pulses your implantable cardioverter defibrillator (ICD) gives aren’t painful. You may not notice them, or you may feel a fluttering in your chest.

The high-energy pulses or shocks your ICD gives last only a fraction of a second and feel like a thumping or painful kick in the chest, depending on their strength.

Your doctor may give you medicine to decrease the number of irregular heartbeats you have. This will reduce the number of high-energy pulses sent to your heart. Such medicines include amiodarone or sotalol and beta blockers.

Your doctor may want you to call his or her office or come in within 24 hours of getting a strong shock from your ICD. See your doctor or go to an emergency room right away if you get many strong shocks within a short time.

Devices That Can Disrupt Implantable Cardioverter Defibrillator Functions

Once you have an ICD, you have to avoid close or prolonged contact with electrical devices or devices that have strong magnetic fields. Devices that can interfere with an ICD include:

• Cell phones and MP3 players (for example, iPods)
• Household appliances, such as microwave ovens
• High-tension wires
• Metal detectors
• Industrial welders
• Electrical generators

These devices can disrupt the electrical signaling of your ICD and prevent it from working properly. You may not be able to tell whether your ICD has been affected.

How likely a device is to disrupt your ICD depends on how long you’re exposed to it and how close it is to your ICD.

To be on the safe side, some experts recommend not putting your cell phone or MP3 player in a shirt pocket over your ICD (if they’re turned on). You may want to hold your cell phone up to the ear that’s opposite the site where your ICD was implanted. If you strap your MP3 player to your arm while listening to it, put it on the arm that’s farther from your ICD.

You can still use household appliances, but avoid close and prolonged exposure, as it may interfere with your ICD.

You can walk through security system metal detectors at your normal pace. Someone can check you with a metal detector wand as long as it isn’t held for too long over your ICD site. You should avoid sitting or standing close to a security system metal detector. Notify airport screeners if you have an ICD.

Stay at least 2 feet away from industrial welders or electrical generators. Rarely, ICDs have caused inappropriate shocks during long, high-altitude flights.

Procedures That Can Disrupt Implantable Cardioverter Defibrillator Functions

Some medical procedures can disrupt your ICD. These procedures include:

• Magnetic resonance imaging, or MRI
• Shock-wave lithotripsy to treat kidney stones
• Electrocauterization to stop bleeding during surgery

Let all of your doctors, dentists, and medical technicians know that you have an ICD. Your doctor can give you a card that states what kind of ICD you have. Carry this card in your wallet. You may want to consider wearing a medical ID bracelet or necklace that explains that you have an ICD.

Maintaining Daily Activities

Physical Activity

In most cases, having an ICD won’t limit you from taking part in sports and exercise, including strenuous activities.

You may need to avoid full-contact sports, such as football. Such contact could damage your ICD or shake loose the wires in your heart. Ask your doctor how much and what kinds of physical activity are safe for you.

Driving

You’ll be asked to avoid driving for at least a week while you recover from ICD surgery. If you’ve had sudden cardiac arrest, a ventricular arrhythmia, or certain symptoms of a ventricular arrhythmia (such as fainting), your doctor may ask you not to drive until you have gone 6 months without fainting. Some people may still faint even with an ICD.

Commercial driving isn’t permitted with an ICD.

Ongoing Care

Your doctor will want to check your ICD regularly. Over time, your ICD may stop working properly because:

• Its wires get dislodged or broken
• Its battery fails
• Your heart disease progresses
• Other devices have disrupted its electrical signaling

To check your ICD, your doctor may ask you to come in for an office visit several times a year. Some ICD functions can be checked remotely through a telephone call or a computer connection to the Internet.

Your doctor also may recommend an EKG (electrocardiogram) to check for changes in your heart’s electrical activity.

Battery Replacement

ICD batteries last between 5 and 7 years. Your doctor will replace the generator along with the battery before the battery begins to run down.

Replacing the generator/battery is less involved surgery than the original surgery to implant the ICD. The wires of your ICD also may need to be replaced eventually. Your doctor can tell you whether you need to replace your ICD or its wires.

What Are the Benefits of Having an Implantable Cardioverter Defibrillator?

An ICD is very effective at detecting and stopping certain life-threatening arrhythmias. An ICD can work better than drug therapy at preventing sudden cardiac arrest, depending on the cause of the arrest.

Although an ICD can't cure heart disease, it can lower the risk of dying by up to 50 percent in some patients who have heart disease.